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D.W. Skufca, R. Trespalacios, R.M. Davis; The XP Microkeratome: Safety and Efficacy of the First 55 Cases . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3602.
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The XP microkeratome is the latest iteration in evolving microkeratome technology by Bausch and Lomb. The previous unit by Bausch and Lomb, the Hansatome, is one of the more widely used microkeratomes today. We evaluate the safety and efficacy of the XP with laser in situ keratomileusis (LASIK) surgery.
The first 55 consecutive LASIK patients (110 eyes or procedures) were retrospectively analyzed. Custom or conventional LASIK was performed in all patients following a standardized in–service by Bausch and Lomb personnel, which included proper assembly. Instruction was also provided on suction ring placement for a nasal or superior placed hinge. Flap hinge placement was nasal in 38 cases or superior in 15 patients. The 8.5/140 head was used in a majority of patients. A single surgeon performed all procedures utilizing the same support staff with a standardized surgical protocol.
The majority of procedures were uneventful in 53/55 patients (96%). One eye of two patients had partially cut flaps and the procedures were not continued. Both of these complications were caused by assembly error of the microkeratome. The remaining 53 patients (106 eyes) formed the basis of the analysis. Qualitative assessment of the flaps demonstrated smooth stromal beds, stepped wound edges, and large diameter flaps compared to Hansatome flaps. There were mild visually insignificant striae in 3.8% (4/106) of flaps noted on the first postoperative day. A subconjunctival hemorrhage was observed in 14% of postoperative patients. Complications were independent of flap hinge placement.
The XP microkeratome is a unique and improved microkeratome representing versatile technology. Proper assembly is critical to avoid intraoperative complications. Qualitative assessment of the flaps in the early postoperative period is superior demonstrating substantive improvements with XP technology. The design of a unique and independent microkeratome head for each planned depth may allow for other possible applications of the XP, such as epi–Lasik and posterior lamellar keratoplasty.
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