LASEK Epithelial Trephines, Alcohol Wells and Corneal Trephines
Instrument guides
LASEK Epithelial Trephines, Alcohol Wells and Corneal Trephines
How LASEK trephines and alcohol wells work, which diameters we make, how double ended Camellin trephines pair a cutting ring with a well, and the other trephines in the range.
In LASEK the epithelium is loosened with dilute alcohol and lifted as a flap instead of being removed. An epithelial trephine scores a circle of a chosen diameter, and an alcohol well or chamber holds the alcohol on that zone for a timed exposure. We make titanium epithelial trephines from 8.0 to 11 mm, Camellin style double ended trephines that pair a cutting ring with a slightly larger well, and alcohol chambers with guides.
How did LASEK begin?
The EyeWiki entry on LASEK credits Dimitri Azar with the first procedure in 1996 and the Italian surgeon Massimo Camellin with naming and popularising it. CRST reported in 2001 that Camellin described his technique in 1998, using a notched trephine to make the epithelial incision with a hinge. Sources differ on 1998 and 1999. His idea was to keep the epithelium as a cover over the treated stroma, rather than leave it bare as in PRK.
Which trephines do we make?
| Instrument | Sizes | Use |
|---|---|---|
| Epithelial trephine, titanium | 8.0, 8.5, 9.0, 9.5, 10, 10.5, 11 mm | Scoring the epithelial flap |
| Camellin style double ended | 8.0/8.5, 8.0/9.0, 8.5/9.0, 9.0/9.5 mm (trephine/well) | Trephine and alcohol well in one |
| Camellin single ended | 8.0 or 9.0 mm | Trephine only |
| Trephine guide and alcohol chamber, Bates, with fixation, titanium | For 8.0 to 11 mm trephines | Holding alcohol on the zone |
| Elliot corneal trephine blade | 1.0, 1.5, 2.0 mm | Small corneal trephination |
| Searcy chalazion trephine | 2.5 or 3.0 mm | Excising a chalazion |
| Troutman punch Teflon base block | Replacement block for corneal punching |
How do you choose the diameter?
The trephine diameter should be a little larger than the planned ablation zone, so the laser treats tissue under the flap and not its edge. The well on a double ended trephine is slightly larger than its cutting ring so the alcohol covers the whole scored zone. The surgeon sets both for the treatment. We make the full range so each case can be matched.
How should trephines be cleaned?
Rinse alcohol and tissue off straight after use. Inspect the cutting ring under magnification, because a nicked ring scores an uneven flap edge. Store trephines so the rings do not touch other instruments. Never leave instruments in saline, because it causes corrosion. Our instrument care guide gives the full routine, and the CDC guidance on cleaning instruments before sterilization explains why cleaning comes before the autoclave.
Frequently asked questions
What is a LASEK trephine for?
Scoring a circle in the corneal epithelium so it can be loosened with alcohol and lifted as a flap.
Why are Camellin trephines double ended?
One end scores the epithelium, the other is a slightly larger well that holds the alcohol over the scored zone.
Which trephine sizes do you make?
Epithelial trephines from 8.0 to 11 mm in half millimetre steps, and double ended Camellin style trephines from 8.0 to 9.5 mm.
Can titanium trephines be autoclaved?
Yes. Protect the cutting ring during sterilization.
Related instrument guides
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