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Microkeratome is physician, patient friendly for predictable flap creation


West Palm Beach, FL-The BD K-4000 (Becton Dickinson Medical/Ophthalmic Systems) is a patient- and user-friendly microkeratome that consistently produces quality flaps with reproducible dimensions, said Jack Daubert, MD.

Dr. Daubert, a private practitioner in West Palm Beach, FL, said the device has been his mechanical microkeratome of choice for the past 5 years. Experience during this period using it on thousands of eyes shows that it performs safely and reliably in creating flaps close to the expected thickness, regardless of what head is used, he said.

"In all our cases, we measure flap thickness using a subtraction technique," Dr. Daubert said. "Based on those data, [we] can conclude the BD K-4000 creates flaps that are, on average, close to the labeled value and with a low standard deviation in mean thickness.

An analysis of outcomes in thousands of eyes showed that the flap thickness was within 10 µm of the expected value 93% of the time.

Dr. Daubert attributes the exceptional performance of this microkeratome in part to its high-quality stainless steel, disposable blades.

This microkeratome is assembled completely off the eye. Its titanium handpiece offers one-handed operation and visualization during flap creation. It has no external gears that can catch the conjunctiva, lashes, or drapes, and it has several features for added safety. The motor stops in the case of suction loss. The blade oscillates only when traversing in the forward direction, and oscillation stops automatically in the event of blade failure.

"Over many years of experience using the BD K-4000, I have never had a single case of a buttonhole or free flap nor any mechanical failures that prohibited me from using this device," Dr. Daubert noted.

This microkeratome is also patient friendly, he said. The instrument gradually builds consistent suction so that patients do not complain about feelings of pressure, and its relatively quiet motor helps to keep patients at ease, he added.

"Some microkeratomes are so loud [that] when they are turned on, the noise startles the patient," Dr. Daubert said. "I don't have to worry about making the patient uncomfortable for that reason when using the BD K-4000."

This microkeratome is marketed with five suction ring sizes, ranging from 8.5 to 10.5 mm in 0.5-mm increments, and four heads to create 80-, 130-, 160-, and 180-µm thick flaps. Although fitting the microkeratome into tighter orbits can present a slight challenge, Dr. Daubert noted that he has not encountered an eye in which it was impossible to use the BD K-4000 or in which it did not achieve good suction.

This microkeratome also receives high ratings from surgical technicians.

"The opinion of an experienced technician is an excellent benchmark for judging surgical instruments, and mine just love the BD K-4000 because it is so easy to assemble and has provided exceptional, problem-free performance," Dr. Daubert said.

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