Comparing consistency of clear corneal incisions using a traditional diamond keratome and a newly designed diamond keratome

Russell J Swan, Julia M Byrd, Daniel I Bettis, Randall J Olson

Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA

Purpose: To compare the consistency of incision architecture utilizing a traditional diamond keratome and a newly designed diamond keratome.
Methods: We used a traditional diamond keratome and newly designed diamond keratome to create clear corneal incisions in human cadaveric donor eyes. Three surgeons with varying levels of experience made 30 incisions with each keratome; and the wound architecture was measured including incision lengths, epithelial and endothelial widths, and the central epithelial incision’s deviation from a straight line entrance.
Results: The mean absolute difference in right and left incision lengths (traditional: 0.182±0.158 mm and new 0.088±0.077 mm [P<0.003]), mean absolute difference in epithelial and endothelial incision width (traditional: 0.181±0.144 mm and new 0.080±0.092 mm [P<0.002]), endothelial incision central deviation from a straight line (traditional: 0.128±0.242 mm and new -0.046±0.124 mm [P<0.001]) were all significantly more consistent with the newly designed diamond keratome than with the traditional diamond keratome.
Conclusion: The newly designed diamond keratome creates a more consistent clear corneal incision than a traditional diamond keratome across a variety of surgical skill levels and does not require advanced levels of training to achieve this consistency.

Keywords: postoperative endophthalmitis, keratome, corneal incision