$1,438.00 – $3,191.00
The hallmark of our diamond paracentesis family is wound closure and the ability to fashion wounds in the hypotonous eye. This is related to ultra-thin, reduced-angle diamond geometries. Mastel has a wide array of diamonds for the side port requirements of any modern ophthalmic surgeon. We provide very cost effective upgrades to standard economy diamonds all with our famous titanium President series handles.
|Paracentesis Diamond|| |
Fine Triamond, Ahmed SuperPentiAhm, Fine ParaTrap, Meister TriFacet, UltraThin Lance, Tanto (formerly SidePort 1.0), Stegmann MicroCrescent
1.0 MM Angled, 1.2 MM, .7/1.2 MM Sharp Tip, 1.1/1.4 Sharp Tip, 1.1/1.4 Truncated Tip, 1.3/1.6 MM Sharp Tip, 1.3/1.6 MM Truncated Tip, .3 MM, 1.0 MM, 7/1.2 MM, 1.1/1.4 MM, 1.3/1.6 MM
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.
Designed in conjunction with Doctor Iqbal ‘Ike’ K. Ahmed, this unique diamond fulfills a number of special purpose features for the cataract/glaucoma surgeon. Since the diamond has five actual cutting edges, it is important to point out that it is essentially a single edge blade to begin with, considering it has only one large cutting edge. This allows a beautiful paracentesis without the concern of inadvertent wound enlargement with patient movement (similar in nature to the metal 15 degree super sharps), yet wounds can readily be enlarged in either direction by rotating the handle 180 degrees, making it extremely versatile yet safe.
Next, the front three edges beginning with the truncated tip allow very clean groove incisions at the bottom of the wound, pierce nearly as well as a sharp tip yet slightly detuned, and allow much easier reentry into an existing incision when compared to a sharp tip blade. The two side angles that follow the tip on either side form what was the classic design in ophthalmology called the trifacet which was actually the first diamond blade geometry in ophthalmology dating back to the 1970s. These two edges are slightly different in length and allow surgeon visualization as depth indicators one being shallower and the other being deeper for freehand groove formation.
On the side that is not to be used for wound enlargement, we feature a sharp enhancement edge which makes a very clean wound margin entry since it trims the entry during a stab. Importantly, this side is turned down toward the globe when wanting to make a more controlled dissection vertically for deep flaps near Descemet’s membrane because the safety bevel acts as a sort of steady rest as it does not cut. So, a surgeon can tease a wound deeper as needed to find the structure planes in these difficult surgical maneuvers. All in all, this is one of the most useful and versatile diamonds we have ever developed.
These diamonds are miniature replicas of our renowned Gimbel SuperStealth trapezoid diamonds used for the phaco wounds. They are very piercing, allowing the surgeon to go in less far or further as desired to create very versatile wound dimensions. For instance, if one is placing iris hooks, then you can just penetrate with the tip to create the smallest internal osteum possible and depending upon surgical need, the surgeon simply continues to enter the anterior chamber until the right size and fit is achieved for routine technique. These are also very easy to enlarge with for those who want this capability as the sides are sharp quite far back, which makes them far more costly to produce. This is Professor Alan Crandall’s favorite diamond.
This is our go-to inexpensive ultrathin diamond designed decades ago with California surgeon Richard Meister, MD. This blade is half the thickness of other diamonds in this price range, which make a real difference in corneal resistance and improved closure. The safety bevel finished, parallel sided blade dimensions ensure that no rough, unfinished square edges that create would leaks at the margins of penetrating wounds occur. It will not enlarge and makes a simple, dedicated one millimeter opening each and every time and is rehonable to original specifications where others are not.
This diamond is a significant step up in performance as compared to our base line Meister blades. It has a piercing tip rather than being truncated (although both point and truncated versions are available) and makes the cleanest entry through Descemet’s membrane possible. This blade features our novel ‘sharp enhancement’ side edges which is essentially a microtrapezoid. The sides appear trapezoidal but have such a short sharp edge on the lateral aspects of the diamond that they clean up the entrance to the wound margins (minimally invasive), yet make a dedicated 1mm opening that cannot be enlarged inadvertently by patient movement (same as the Meister in this respect).
Named after the Japanese short knife, the Tanto is the ultimate in simplicity of design, yet is very affordable as a result. This is due to the simpler faceting of which is pretty much a double edge blade. This is a variation of the 15 degree super sharp in metal, as it will only enlarge in one direction and makes a straight forward stab wound relatively simply and works well in any situation including the hypotonous eye. The sharp enhancement on the dull side makes the penetration very smooth, and again, cleans up the wound margin on that side of the paracentesis.
This blade also lends itself to the same maneuvers as the SuperPentiAhm in that it can be turned upside down to control depth of incisions in a freehand method as outlined in the video below by Doctor Jeshal Patel (South Africa).
It does not allow for controlled depth grooves in routine cases as there are not sufficient landmarks to judge depth. If this is a goal, then consider this diamond in our PhD step handle. Finally, Doctor Patel has discovered a unique method to use this blade for flap dissections in a very controlled and safe manner, which was a hidden benefit until he discovered it and pointed it out to Mastel.
Although the look of this blade would make one think it would not pierce well for a paracentesis, it is surprisingly good yet not as stealthy as the ParaTrap or Triamond. One just needs to wait a little bit for it to enter and some prefer it because it feels a lot more controlled. It does not allow the extent of trapezoidal margins for making smaller or larger wound architecture. It is ideal for combined applications where the surgeon might have needs for controlled lamellar dissections such as trabeculectomies or corneal pocket dissections, while some prefer it due to the control it has for grooves and AK’s.
The President Series handle features a double threaded mechanism for robust, simple actuation. The mechanism locks securely to eliminate free play of the stylus. The titanium construction and elimination of springs makes them virtually indestructible in clinical service. The President serves as the platform for phaco keratomes, paracentesis blades, glaucoma blades, groovers and any freehand application. The diamond is extended straight or at an angle for maximum clearance and accessibility.
The Danger of Unfinished Lateral Edges
The hard corners of unfinished square (90°) corners are ALWAYS REMOVED AT MASTEL. They are actually cutting edges on their own (albeit very dull ones), and they create wound margin defects if not removed. With a simple spear or lance, the sides of the blades are left rectangular, which means you have these ‘hard corners’ or edges above and below the plane of the dissection that has been advanced into the eye. We have not provided these designs to anyone for over a decade because they are wrong. Most wound leaks from the diamond paracentesis profile IS designs are due primarily to this lack of faceting acumen and should not be offered.
"The Opening Determines the Close"
Histological and ultrastructural study of corneal tunnel incisions using diamond and steel keratomes
“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