April 1, 2021

How Mastel’s UltraThin Diamond Blades have lowered the chances of elevated IOP

How Mastel’s UltraThin Diamond Blades have lowered the chances of elevated IOP [Retrospective Study]

Elevated Intraocular pressure is a burden and danger to Ophthalmologists worldwide. Complications with some procedures will cause that patient to develop glaucoma from elevated intraocular pressure and if it goes untreated, will lead to blindness. In this post we discuss elevated intraocular pressure (ocular hypertension or IOP) and how Mastel’s UltraThin diamond blades have minimized ocular hypertension in surgeries.

Danger of Elevated Intraocular Pressure

When pressure from the aqueous humor in the eye begins to not drain properly out the trabecular mesh-work, that fluid will build up causing strain on the eye and damaging the optic nerve leading to potential blindness. High pressure in the eye can go unnoticed.
Pressure in the eye is measured with millimeters of mercury. Normal eye pressure is between 10-20mmHg. Too low, (less than 6mmHg) and the eye develops ocular hypotony which causes several distortions in the eye, and degrading vision. Ocular hypertension is considered greater than 21mmHg, and causes damage to the optic nerve and may lead to glaucoma.

What causes Ocular Hypertension

Ocular hypertension is common in:

Persons families that have a history of glaucoma
who have high blood pressure or diabetes
who are very myopic (nearsighted), and
who have had eye surgeries or injuries.

Mastel’s UltraThin Diamond Blades have lowered the chances of elevated Intraocular Pressure [Retrospective study]

Christoph F. Kranemann, MD and a team from Clearview Institute, Toronto, Ontario conducted a retrospective study where two groups of patients who underwent clear corneal phacoemulsification to compare incision technologies. The first group’s main and side port incisions were created with an UltraThin Mastel diamond blade. The Second group’s main and side port incisions were created with a disposable metal keratome.
The first group had no postoperative wound leaks, and the mean IOP 8 hours after surgery was 19.2mmHg, still in the normal range for eye pressure.
The Second group, that used disposable metal keratomes for both incisions had a total of 9 wound leaks and the mean IOP 8 hours post-op was 21.6mmHg, high enough to be considered ocular hypertension. Only 4.55% of the first group experienced an early IOP spike, while 10.18% of the second group experienced an early IOP spike. [View Study]

At the conclusion of this study Dr. Kranemann and his team stated: “the use of Mastel diamonds for the incision significantly reduced the rate of wound leaks and the amount of wound hydration resulting in lower early postoperative IOP’s and potentially dangerous IOP spikes”. [View Study]

Conclusion

Elevated intraocular pressure can be caused by the integrity of material used in making incisions. Mastel offers Ophthalmologists the opportunity to equip themselves with a more efficient alternative than standard disposable steel blades. Mastel’s ultrathin diamond knives may be a more expensive investment but the quality, life, and service provided is un-matched. Mastel continues to produce the premium ultrathin diamond blades that have been serving Ophthalmologists since the 1990’s.

For any other questions, comments, concerns contact a Mastel Customer Service Representative through our Contact Page.

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December 27, 2018

How to Maintain Your Diamond Scalpel

Admin Education, Mastel Diamond Knives

Over the decades, I have been asked many times how many cases one should expect to get off of a single diamond scalpel. My answer has been modified to where I now simply quip “anywhere between zero and infinity.” As corny as it sounds, it is actually true. Below, I will discuss the six steps to keeping your diamond scalpel performing like new for years to come.

Before Use:

Step 1. Limit diamond scalpel handling to experienced staff only.

We have had numerous experiences where a distraught surgeon or nurse has called us during or immediately after a procedure to tell us the blade was broken off or dull. This is almost always the result of mistakes in staff handling. As simple as this sounds, the diamond journey begins with who might open and handle your packages with instruments in receiving to who then moves them along to your surgical team. Careful thought should be given here to an area one would not normally have a concern about. Less people handling diamonds in any organization is always better.

Step 2. Inspect and sterilize diamond scalpel upon receipt.

Upon receipt, and after the diamond scalpel has been critically inspected under the surgical microscope by the surgeon or experienced staff member, the diamond scalpel can be sterilized as denoted in our verified sterilization documentation, Packaging and Sterilizing Mastel Precision Diamond Knives (visit mastel.com/faq).

Step 3. Keep the diamond scalpel retracted and isolated when not in use.

If the diamond scalpel is simply touched to anything other than soft tissue, it will be damaged. The most common mistakes causing diamond scalpel breakage that I have witnessed are the following:

Touching another instrument or the speculum
Setting the diamond scalpel on the mayo stand with the blade extended where it can roll around and run into something
Setting the diamond scalpel where another instrument could poke up into the barrel (even if retracted!)
Sending an instrument in the mail without its case or properly protecting it

Note: If this happens to you, it is important to never use a blade that is dull by “forcing it,” as this can lead to complications. Ask for another scalpel if it does not feel right.

During Use:

Step 4. Cautiously decide who extends and retracts during surgery.

The surgeon in a new setting (or with new assistants or ancillary personnel) should be the only person to extend and retract the blade during the procedure. With experienced staff, however, it can be far more efficient for the assistant to extend and retract the diamond for the surgeon.

After Use:

Step 5. Clean debris off of the diamond scalpel immediately after usage.

After usage, we strongly recommend using the Mastel Diamond Blade Cleaning System in the OR. We then recommend placing your retracted diamond scalpel in the sterilization case that precludes the round instrument from rolling around and also ensures staff outside the OR do not touch these these ultra-delicate devices apart from sterilization.

Note: It can be extremely difficult to clean the diamond as compared to other micro instruments. Due to the nature of single crystal diamond being oil wettable and not water wettable {as are most materials such as metals}, it has an extreme affinity to have tissue, blood or viscoelastics dry on and not be removed with normal cleaning approaches. It requires soap or other surfactants that lift the material from where it desires to stick. If you were to bake on these biological materials just one time, it becomes a significant challenge to get them clean again. It does not look good and can degrade the performance at the same time.

Step 6. Send in your diamonds for annual inspection.

Any diamond scalpel has the inherent weakness of the epoxy bonding the diamond to the metal dop (or holder). With Mastel diamonds, we recommend that the mountings be checked on an annual basis depending upon volume because the diamonds can loosen or fall out, neither of which is pleasant. On controlled-depth handles, this is a critical error. It is the autoclaving cycle that destroys the integrity of the epoxy resins used by all companies in the industry. Good maintenance protocols should involve your vendor’s expertise and insight.

By Doug Mastel