The micrometer diamond scalpel is the ultimate instrument for adjustable depth control. Our design features 10 micron intervals on the thimble and a thread pitch of 500 microns per revolution. Normal depth settings in Corneal Relaxing Incisions (Astigmatic Keratotomy) range from 500 to 800 microns dependent upon corneal thickness and a 90% depth setting. The Elite II™ comes with two footplate options: Inset Profile or Profile.
This scalpel comes with the Fine Triamond diamond, which is a superbly versatile and robust diamond. It is excellent for corneal relaxing incisions, paracentesis and wound enlargement as needed. The flexibility and ultimate sharpness of this diamond geometry is a favorite with many surgeons. It features long side cutting edges (4.5mm) that work for most ophthalmic dissection needs.
Inset Profile (Used w/Guide Ring), Profile (Used w/Compass), Davis Doubler
This has been our most popular diamond throughout the years and it features as the standard diamond in our LRI diamonds including the Nichamin Classic 600, our Elite II Micrometer and PhD II Step diamond handles. In the freehand version, the 300 micron tip allows very easy penetration, and the long sloping side edges allow the surgeon to go in further or less far depending upon the wound dimensions so desired. This is very similar in all aspects to the Fine ParaTrap but is better for LRI and very uniform lateral side edges set at 7 degrees from the center line, making wound enlargement a breeze in practically any application. Again, this is a premium diamond due to the cost of producing such long and versatile edges.
This premium diamond was originally developed in the early 1990’s during the era of Radial Keratotomy. Prior to this, surgeons either cut centrally (Russian technique) or peripherally (American technique). The Doubler (David Davis, MD, Hayward, California) was developed to combine the safety of the American approach, but the efficiency of the Russian approach.
This blade is highly efficient in terms of vectors. The oblique, radial cutting edge is at 20° from vertical, so it cuts very deeply. The vertical edge, facing the central optical zone, has a 200 micron sharp edge that then transitions to dull (safety bevel). This allows the surgeon to initiate a radial incision at the central optical zone. The entire incision is then deepened back to the center where the safety bevel precludes inadvertent extension through the central clear zone.
The Inset Profile footplate centers the blade within a small notch with two guide rails supporting the blade on both sides. This footplate glides smoothly along the epithelium and provides enhanced applanation and critical depth control. It is suitable for use with any of our popular LRI/AK guide rings due to the fact that the twin side rails support contact on the guide ring surface (see Guide Rings). All this means better alignment and feel for the surgeon performing arcuate keratotomy.
The Profile footplate was our original, single-ski footplate upon which the Nichamin NAPA nomograms (Nomograms Adjusted for Pachymetry and Age) were developed. Rather than directly below the diamond, the supporting downrail is slightly offset to allow better visualization for the surgeon operating in the peripheral cornea. This footplate smoothly glides along the epithelium and provides critical depth control and applanation. It is not compatible with our guide rings, but pairs well with the Compass.
Radial Keratotomies require applanation on both sides of the diamond. This radially inline footplate features ‘Diamond Forward’ positioning. The leading edge is just in front of the footplate, facilitating surgical visualization. This allows for the creation of unidirectional astigmatic keratotomies. The combination of this footplate and diamond can be used for newer techniques of corneal relaxing incisions.
In the following video, Dr. Jason J. Jones, MD demonstrates surgical use of the Elite II Diamond Micrometer.
“The corneal incisions made with the dissecting, stiletto-like keratomes (Mastel Fine Triamond) were distinct from the other incisions, having a smoother stromal surface and much less disruption of stromal tissue. The dissecting incision using the stiletto-like diamond keratomes was ideal with respect to the degree of disruption of stromal tissue.”
Journal of Cataract and Refractive Surgery, Volume 24, Number 4, April 1998
Jacobi et. al., Giessen University, Munich, Germany, Pages 498-502