探寻Amadeus II微型角膜刀制作高质量角膜瓣的最佳参数设置
Amadeus II microkeratome: optimizing microkeratome settings for high flap accuracy using optical low coherence reflectometry.
Eur J Ophthalmol. 2010 Jan-Feb;20(1):41-7.
Lackerbauer CA, Kollias A, Kreutzer TC, Ulbig M, Kampik A, Grueterich M.
Source
Department of Ophthalmology, Ludwig-Maximilians-University, Munich - Germany. Carlo.Lackerbauer@med.uni-muenchen.de

Abstract
PURPOSE:
To investigate the impact of various experimental microkeratome settings and blade reuse on the accuracy of the flap thickness created with the new Amadeus II microkeratome (SIS, Ziemer Ophthalmic, Port, Switzerland).

METHODS:
In this prospective study, 120 porcine eyes were used to create corneal flaps with the Amadeus II using 2 different cutting heads (140 microm, 160 microm) with the Surepass blade. Using each blade twice, a head advance speed of 1.5 mm/s and 3.5 mm/s and oscillation rates of 8000 rpm, 10,000 rpm, and 13,000 rpm were used. Flap thickness was measured by optical low coherence reflectometry (OLCR). Descriptive statistical analysis was based on means, medians, and quartiles, with graphical representation on box plot. Pearson correlation test and Mann-Whitney U-test for unpaired samples were employed to identify the impact of different settings.

RESULTS:
Using the 140 microm cutting head, highest precision of the flap thickness was achieved with a head advance rate of 1.5 mm/s and an oscillation rate of 10,000 rpm (mean 132.1+/-10.0 microm; range 120.2-147.2 microm). Reusing the blade, highest accuracy (mean 130+/-6.9 microm; range 118.5-135 microm) was achieved with 8000 rpm. Using the 160 microm cutting head, an optimum flap thickness was reached with a head advance rate of 3.5 mm/s and an oscillation rate of 13,000 rpm (mean 162.4+/-7.7 microm; range 151.9-169.8 microm). Reusing the blade with the 160 microm cutting head, an adjustment to 3.5 mm/s and 10,000 rpm was necessary (mean 157.4+/-7.7 microm; range 153.7-161.8 microm).

CONCLUSIONS:
Optimized microkeratome settings lead to minimized deviation from the intended flap thickness and are mandatory to improve flap accuracy. OLCR is an ideal method to proof individualized settings.

　　这项研究于2011年1月发表于欧洲眼科学杂志上，旨在探寻Amadeus II微型角膜刀制作高质量角膜瓣的最佳参数设置。在这个前瞻性研究中，120个猪眼被用于制作角膜瓣。分别采用2个刀头（140um和160um），每个刀片用两次（相当于一个人的两只眼），前进速度分别为1.5mm/s和3.5mm/s，振动频率分别为8000转/m，10000转/m，13000转/m。利用光学低相干反射生物测量仪测量角膜瓣的厚度。结果显示，用140um刀头，最精确角膜瓣厚度参数为前进速度1.5mm/s，振动频率10000转/m，此刀片第二次使用时，最佳参数为振动频率8000转/m。用160um刀头，最佳参数为前进速度3.5mm/s，振动频率13000转/m，第二次使用刀片时，最佳参数为前进速度3.5mm/s，振动频率10000转/m。
　　　　　　　　　　　　　　　　　　　　　　　　　　　　（黄正 译）