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Status: Ready for the Market

Device for performing microsurgical eye operations

The PocketMaker ultrakeratome is a milestone of modern corneal surgery in terms of cutting accuracy and safety. It allows to perform precise cuts with micrometre-range accuracy at virtually any corneal depth. The precision and quality of the performed cut is unique and cannot be achieved with any other tool, not even with a femtosecond laser system that is several times more expensive. The PocketMaker ultrakeratome is used in implant surgery, transplant surgery and, in combination with the add-on system ‘artificial anterior chamber’, also in corneal banks to create prefabricated transplants.

Unmatched precision and cutting quality

The micrometre-range cutting accuracy and quality of the PocketMaker technology in a living cornea is unmatched. The data below show the result of a related study on the living eye in corneal implant surgery using OCT (Optical Coherence Tomography) measurements at a predefined cutting depth of 300 micrometres over a cutting surface diameter of 9 mm. No other surgical system is able to achieve such excellent cutting quality and repeat accuracy.

The PocketMaker is an ultra-thin, perfectly sharpened diamond blade with a cutting edge that tapers to atomic level. The blade is guided over a surface up to 9 mm in diameter, performing a high-precision cut in the cornea to a predefined depth.

The pictures below show the difference between a PocketMaker and a femtosecond laser cut immediately after performing a 9 mm-diameter slit with a corneal depth of 300 micrometres in a living eye. The perfect cutting performance of the PocketMaker compared to the fairly rough cutting surface achieved by the femtosecond laser is clearly visible.

The following video shows the use of the PocketMaker in corneal implant surgery while creating a closed gap with a diameter of 9 mm to a depth of exactly 300 micrometres.

Unlike the femtosecond laser, the PocketMaker may also be applied on a cornea with scars and opacities. The PocketMaker ultrakeratome is used in implant surgery, transplant surgery and, combined with the add-on system ‘artificial anterior chamber’, also in corneal banks to create prefabricated transplants.

The following video shows how the PocketMaker is used in a Buddhist monk in Southeast Asia, who turned practically blind after a severe chemical burn of the eye. The very next day after having an artificial cornea implanted in his eye by the PocketMaker technique, his visual acuity returned to 20%.

Scientific literature

1. Irschick E, Siepe U, Pöttinger E, Ettl A, Daxer A, Kieselbach G, Philipp W, Ulmer H, Falk M, Göttinger W (1995) Achtjähriges Follow-up von Hochrisiko-Keratoplastiken nach Kurzzeit-Cyclosporin A-Therapie. Spektrum Augenheilkd 9:169-174.

2. Daxer A. (2008) Corneal intrastromal implantation surgery for the treatment of moderate and high myopia. J Cataract Refract Surg 34:194-198.

3. Daxer A (2008) Corneal Intrastromal Implantation Surgery. Cataract & Refractive Surgery Today Europe 3:63-64.

4. Daxer A (2010) Adjustable Intracorneal Ring in a Lamellar Pocket for Keratoconus. J Refract Surg 26:217-221.

5. A. Daxer, H. Mahmoud and RS Venkateswaran (2010). Corneal cross-linking and visual rehabilitation in keratoconus in one session without epithelial debridement: new technique. Cornea 29:1180-1185.

6. H. Mahmoud, RS Venkateswaran and A. Daxer (2011) Implantation of a Complete Corneal Ring in an Intrastromal Pocket for Keratoconus. Journal of Refractive Surgery. 27:63-68.

7. G Bikbova, M Bikbov and A Daxer (2012) Descemet Stripping PocketMaker Endothelial Keratoplasty. International Journal of Keratoconus and Ectatic Corneal Diseases 1:125-127.

8. A Daxer (2015) Biomechanics of Corneal Ring Implants. Cornea 34:1493-1498.