instrument insider
Diamond Phacokeratomes from Rumex International
Reviewed by Rex Hsei, M.D.

As a surgeon co-owner of a small ophthalmic ASC, I strive to maximize both quality and cost-effectiveness when selecting surgical instruments. At our center we perform more than 1,000 cataract extractions a year, nearly all using clear-corneal incisions under topical anesthesia, so choosing an excellent phacokeratome is essential.

We've been using diamond phacokeratomes from Rumex International for several years; we've found them to be of high quality and a good value. They have sharp blades that provide reproducible incision size and architecture. They're also durable, and they can be retracted into the keratomes' ergonomic titanium handles.

	Four diamond knives from Rumex International, all sharpened using the Thermo-Cut process: (left to right) the Facet-Free Crescent Knife, the Trapezoid Self Diving Knife, the Zaldivar Blade, and the Multi-Incision 1.0-mm Blade.

Sharpness Counts

I use the Rumex self-diving trapezoid diamond blade (diam. 2.60/2.90 mm) to make single-plane, self-sealing, clear-corneal, temporal incisions. Clear-corneal cataract surgeons know that a sharp blade is necessary for consistent, self-sealing wounds. I've found the Rumex phacokeratome to be so sharp that I can make my main temporal incision immediately following the initial paracentesis, without first needing to inject viscoelastic material. (This reduces the tendency for an early, shallow entrance, which can occur when the anterior chamber is over-inflated.) The sharpness of the blade also allows me to make the incision with minimal counter-traction on the globe, using a Weck-Cel sponge at the opposite limbus.

Properly size-matched for our sleeved phacoemulsification system, incisions made with these keratomes don't leak during the procedure. More important, they're self-sealing, with minimal stromal hydration at the conclusion.

Overall, I've found that these phacokeratomes allow an economy of movement and instrumentation that wouldn't be possible with a duller blade.

Maintaining Quality

Like most well-maintained diamond knives, Rumex phaco- keratomes perform more than a thousand cataract cases before needing to be sharpened or replaced. This durability, combined with competitive pricing, has allowed our center to maintain the highest quality at a great value.

Dr. Hsei is a board-certified ophthalmologist in private practice in Santa Cruz, Calif., and is medical director of Cypress Outpatient Surgical Center. He can be reached at drhsei@santacrzeyedoctor.com. Dr. Hsei has no financial interest in Rumex or its products.