Volume II Issue 4

Originally published, Sunday, March 11, 2001

Laser Clean Room eliminates contaminants during surgery

ULPA filters in Mastel’s Laser Clean Room remove dangerous compounds and microbial agents released during LASIK. The patient, staff, and surgeon are protected.

Microscopic environment controlled
to optimize results

JENKINTOWN, PA _ The Mastel Laser Clean Room was designed to remove potentially harmful airborne debris from the LASIK operating suite. It works.
“I was happy with the added safety this unit provided my patients and staff. That would have been enough”, said James Lewis, MD, a LASIK specialist. “I didn’t expect this device to improve my clinical results.”
Lewis continues, “Doug Mastel insisted I’d have better post-operative outcomes…. He’s correct and now it all makes sense.”
During LASIK the excimer laser is applied in a series of pulses. After each pulse vaporized corneal tissue rises from the surface. Pulses occur so rapidly they hit the rising particles from the previous pulse. The laser energy delivered to the cornea is distorted and inefficient.
“It is like driving through fog. The headlights work but resolution is impaired”, Lewis claims. “Elimination of this particulate debris allows each laser application to remove the planned amount of corneal tissue without distortion.”
The Laser Clean Room creates a controlled microscopic environment for LASIK. The particles are absorbed before the next pulse is applied. This ensures stabilized corneal hydration and reliable excimer corneal sculpting.
“The hot buzz word today is eye tracker. Mastel uses fixation [see the handpiece below] and the best supercomputer I know to optimize placement of laser energy. That supercomputer is the union of the patient’s feedback and the surgeon’s years of experience. This helps explain the improved results.”, Lewis said.
“The patients are reassured because we help them hold their eye still”, claims Sue Cross, head LASIK coordinator. “I can feel their anxiety lift when they learn we are in total control.”
The fiber optic visualization system Mastel added took years to perfect. This enhanced view helps the surgeon.
“The light source included makes it easy to center the laser energy. This is fundamental for patients with large pupils and night driving concerns”, claims Lewis. “I can be certain the ablation is well positioned and the interface is immaculate.”
Mastel Precision is known for innovation and the development of quality products. A decade ago their diamond blades and Radial Keratotomy instrumentation was without peer. Doug Mastel and his brother are engineers and they closely supervise and direct all research and development.
“I am relieved there is still a place for this kind of pride, dedication, and perfectionism in our field. I feel like I have a partner in every surgery”, Lewis said.
Surgeons throughout the country are reporting an improvement in visual results using the Laser Clean Room. Many feel their enhancement rate is reduced because the surgical micro-environment has been made more uniform.
“There is less visual fluctuation, less regression, and greater accuracy now that I use it [Laser Clean Room] in every case”, Lewis stated. “I don’t think my staff or my patients would tolerate it any other way.”

Laser plume evacuator handle with attached fiber

Doug Mastel’s device enhances LASIK safety for patients, staff, and your surgeon

RAPID CITY, South Dakota _ LASIK is effective because unwanted corneal tissue is painlessly removed. The aerosilized material is called the plume.
Live oral polio virus has been found to survive and remain infectious in the LASIK plume. MJ Travella, a respected researcher specializing in the properties of the excimer laser plume has eliminated most of our worries concerning transmission of other serious disease entities.
Responsible surgeons protect their staff, their patients, and themselves with multiple safety mechanisms.
LASIK’s excellent history and safety profile are encouraging. Mastel, however, designed the Laser Clean Room to remove unwanted compounds. Their Ultra Low Penetrating Air (ULPA) filters remove 99.9999+% of particles down to one-tenth of a micron. Viral particles, carcinogenic hydrocarbons, and aromatic hydrocarbons are eliminated.
HEPA filters, common in other laser plume evacuators address only 98.7%. Material three times larger than those handled by ULPA filters get past the HEPA devices. These escaped compounds can enter the lungs and bloodstream.
“I can smell the difference”, said Debbie Breig. Ms. Breig, an outstanding scrub nurse who has worked at Wills Eye and has assisted in LASIK before joining Advanced Laser Vision.
“I am more confident that potentially dangerous debris is removed before it can reach the patients and the staff”, Breig continues.
Mastel has also added an carbon activated filter to the system. It removes non-biologic substances.
OSHA, the federal agency regulating safety in the workplace, recommends thorough excimer laser plume evacuation.

Dr. Jamie Ellsworth-Neiman is reassured that her LASIK was performed using the Laser Clean Room.

Personalized instrumentation for each
LASIK patient

The Moria One Disposable maximizes sterility,
efficiency, precision, and quality.

Bartell brings surgeons new technology

Moria S.A., a French company serving the needs of Ophthalmologists for 180 years merged with Microtech, INC of Doylestown, PA, in June, 2000.
Mike Bartell, president and founder of Microtech along with his partner Charlie Mastellone are now co-chief operating officers of the new company, Moria, INC.
“There is a strong emphasis on disposables for LASIK surgery throughout Europe”, Bartell stated in a telephone interview this week. “The labor-intensive sterilization requirements make the convenience of the Moria One Disposable extremely attractive.”
Brian Pirollo of Moria, INC., said, “The accuracy and reliability of this device are outstanding. Surgeons who have tried it are convinced almost immediately. Most feel it is well worth the increased cost.”
“With the Moria One Disposable no one has to touch and potentially dull the extremely delicate blade. High volume surgeons and even surgeons with a lower case load will be drawn to its benefits”, Bartell continued.
James Lewis, MD, Medical Director of Advanced Laser Vision thought the instrument would be ideal for select cases. “I never thought a LASIK flap could be so precise, reproducible, and clean”, said Lewis.
“Once I saw how well the Moria worked, I knew we had to provide this quality to every LASIK patient”, Lewis continued. “You just can’t measure the value of a faster recovery.”
Bartell broke new ground in 1987 when he patented the inserter for foldable intraocular lenses. It took 4 years for the FDA to approve these lenses and another four years of patent litigation before his contribution was recognized. Now virtually every foldable intraocular lens used during cataract surgery relies on Bartell’s innovation (and patent).
The housing for the Moria One Disposable blade is shown below. It arrives sterile, inspected, and assembled. It is custom ordered and adjusted for every patient and discarded after a single use. Cross-contamination, corneal toxicity, instrument damage and sterilization failure are virtually eliminated.
“Forget the ease of use and faster turnover, this simply cuts a better flap. It is thin, uniform, and reproducible. I love this thing…and so do the patients”, Lewis said.
Dr. Fabriziani saw the first round of post-operative Moria One Disposable patients twenty-four hours after LASIK. He claimed, “The worst vision I measured today was 20/20. Most of my patients were 20/15.”
“I am having trouble even seeing where the surgery was performed. The eye heals overnight”, Fabriziani continues.
“There is no secret that Mike Bartell is a winner. He remains humble despite his extraordinary accomplishments”, Lewis continued. “I am glad he has turned his attention to LASIK. We benefit from his almost intuitive assessment of quality. He will help all of us to be better surgeons.”

Housing for Moria One Disposable Microkeratome

© Copyright Moria, INC.

Advanced Laser Vision becomes first to use Disposable Microkeratome Exclusively

JENKINTOWN, Pa_ “He [James Lewis, MD] is never satisfied”, according to Sue Cross, chief LASIK Coordinator. “If there is new technology and it works……you can bet we’ll be the first to have it”.
“We like the concept of disposable instrumentation”, said Dr. Marc Myers. Myers is the newest member of the LASIK team. “There is a reduced risk of DLK (Diffuse Lamellar Keratitis), cross-contamination, and instrument damage.”
Tuyet Wong, RN was one of the early patients to benefit from the new instrumentation. She is pictured below immediately after LASIK with her husband, Bruce Wong, MD.
Dr Wong, a physician and the new Vice President of Outcomes Research at Bristol-Myers also had LASIK at Advanced Laser Vision a year ago.
“We used the Carriazo-Barraquer [microkeratome] for Dr. Wong’s surgery“, continued Dr. Myers. “At the time, we thought it couldn’t get better than that.”
Tuyet and her husband have seen 20/20 (and sometimes 20/15) in each eye at every postoperative visit.

Robert Hayes (below) didn’t let the residual eyelid antiseptic stop him. He started to put his own microkeratome through the paces after he walked from the operating suite.
“Since we began using the disposable I’ve been amazed with the patient’s rapid visual recovery”, explained Dr. Myers.
Just minutes after LASIK Robert Hayes is focused on surgical technique. Perhaps he is planning a career change.

Robert Hayes tinkers immediately after LASIK.