New device brings changes to microkeratome technology.

The Amadeus II microkeratome [Advanced Medical Optics Inc. (AMO)] is a technologically advanced instrument that brings LASIK flap creation to new levels of simplicity, safety, and reproducibility, agree refractive surgeons who have used the new-generation device.

Another surgeon, Kerry Assil, MD, has used the Amadeus II in about 65 procedures.

He added that he has encountered no complications so far.

A versatile instrument The Amadeus II is a highly versatile instrument. It comes with 8.5-, 9-, 9.5-, and 10-mm suction rings and features a standard plus a narrow head that allows the microkeratome to rest safely and more comfortably in patients with tight intrapalpebral fissures.

In addition, surgeons are able to adjust hinge width, oscillation speed, and translation speed, and the Amadeus II is also the first microkeratome that allows for altitude adjustment to maximize suction performance.

"This device enables full customization of flap creation parameters, and by providing voice confirmation, it eliminates the potential for surgeon or technician error in entering the desired variables," explained Dr. Assil.

Since surgeons can also alter the suction ring aspiration level via the console setting, with the various plate sizes available, achievable flap thicknesses can be varied in the range from 115 to 170 µm.

"This feature provides for a little more flexibility in flap thickness," Dr. Assil said. "For example, using the 140-µm plate and lowering the aspiration setting from 24.5 to 22.5 mm Hg, it is possible to achieve a thinner, 120-µm flap."

He added that by further refining the tolerances of flap thickness, the risk of unusually thick flaps appears to be reduced with the Amadeus II.

"As a result, this microkeratome is especially friendly to the corneal epithelium and should be associated with less likelihood for epithelial softening or epithelial defects associated with flap creation," Dr. Assil continued.

The Amadeus II is also well designed from an ergonomics standpoint. Its titanium handpiece and power cord are especially small and light. As a result, the microkeratome can be more readily positioned onto the eye and there is decreased likelihood for suction break.

"Those features translate clinically into greater ease of flap creation," Dr. Assil said.

As another safety bonus, improper assembly is no longer a concern because the Amadeus II is designed with automatic assembly guides.