K Number
K014000
Manufacturer
Date Cleared
2002-03-11

(97 days)

Product Code
Regulation Number
886.4370
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Visitome 20-10 Microkeratome is intended for use in the making of a corneal flap in patients undergoing LASIK surgery or other treatment requiring initial lamellar resection of the cornea.

Device Description

The Visitome 20-10 Microkeratome is an AC-powered device that is used for making a flap by incising the cornea at a predetermined thickness and diameter using a high-speed oscillating blade made of stainless steel. The device consists of the following main components and accessories: the control unit, a surgical unit (handpiece with drive assembly, positioning ring assembly, applanator assembly, and a stainless steel blade holder), a foot pedal, tubing kit (accessory), and a fluid collection container (accessory).

The Visitome 20-10 Microkeratome contains a positioning ring which allows the cornea to protrude through the ring. The cornea is restrained by an applanation shoe surface, which may be pivoted away. A stainless steel blade is suspended from the end of the positioning ring by a blade support (holder) which is driven by a drive mechanism, so that the blade moves along a forward path between the positioning ring and the applanation shoe while oscillating laterally. Drive control and vacuum for the positioning ring are provided by user command via the control unit and foot pedal.

AI/ML Overview

Acceptance Criteria and Study for VISITOME 20-10 MICROKERATOME

Based on the provided 510(k) summary for the VISITOME 20-10 Microkeratome (K014000), here's an analysis of the acceptance criteria and the study performed:

1. Acceptance Criteria and Reported Device Performance

The 510(k) summary primarily relies on demonstrating substantial equivalence to a predicate device (Hansatome Microkeratome, K010260) rather than presenting a formal table of explicit acceptance criteria with numerical targets. Instead, the "acceptance criteria" are implied by the claim of equivalence in technological characteristics, safety, and effectiveness. The performance evaluation focuses on whether the device meets all performance specification requirements to be considered equivalent.

The comparison table outlines the technological characteristics of both devices, which serve as the basis for demonstrating equivalence in performance.

CharacteristicPredicate Device (Hansatome Microkeratome)VISITOME 20-10 Microkeratome (Reported Performance)Implied Acceptance Criteria (for equivalence)
Indications For UseMaking a corneal flap for LASIK/lamellar resectionMaking a corneal flap for LASIK/lamellar resectionSame indications for use.
Operating PrincipleElectrically driven oscillating blade, gear rack, footswitch controlElectrically driven oscillating blade, gear rack, 3-pedal footswitch controlElectrically driven oscillating blade, similar mechanism for advancement and control.
Type of Hinge or FlapNasal and SuperiorNasal and SuperiorCapability to create Nasal and Superior hinges/flaps.
Manual or Automatic Blade AdvancementAutomaticAutomaticAutomatic blade advancement.
Blade Advancement RateUnknown1 to 10 mm/secFunctionally appropriate range for corneal flap creation. (No direct comparison is made due to "Unknown" for predicate)
Oscillation RateUnknown0 to 12,000 rpmFunctionally appropriate range for corneal flap creation. (No direct comparison is made due to "Unknown" for predicate)
Flap Diameter Resection8.5 & 9.5 mm; accuracy unknownRange of 7.5 to 10.5 mmCapability to resect flaps within a clinically acceptable diameter range.
Thickness of Resection160 & 180 microns120, 160 & 180 micronsCapability to resect flaps at clinically relevant thicknesses. (VISITOME offers more options)
Eye Fixation MethodSuction Ring (sizes 8.5 & 9.5 mm)Suction Ring (sizes 10.5, 11.5, & 12.0 mm)Use of a suction ring for eye fixation. (VISITOME offers different sizes)
Disposable Blade with Fixed Holder?YesYesDisposable blade with fixed holder.
Blade Angle25 degrees32 degreesClinically effective blade angle for corneal incision. (Difference accepted as not affecting safety/effectiveness)
Keratome Blade MaterialStainless SteelStainless SteelStainless Steel blade material.
Handpiece MaterialStainless SteelTitaniumBiocompatible and durable material for the handpiece. (Difference accepted as not affecting safety/effectiveness)
Components That Contact the PatientBlade, Keratome Head, Suction RingBlade, Suction RingBiocompatible and properly sterilized components in contact with patient.
Safety Features1. Internal diagnostics, 2. Vacuum check before cut, 3. Cut stops if vacuum drops.1. Internal diagnostics, 2. Vacuum check before cut, 3. Alarm/cut stops if vacuum lost.Comparable safety features to prevent adverse events.

2. Sample Size Used for the Test Set and Data Provenance

  • Sample Size: The document explicitly states "The device underwent performance evaluation testing in pig eyes." It does not specify the number of pig eyes used.
  • Data Provenance: The testing was conducted in "pig eyes," indicating an in vitro or ex vivo animal model study. This is prospective testing performed for the device. The country of origin of the data is not specified, but the applicant company is Biovision AG from Bern, Switzerland.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

The summary does not mention the use of experts to establish ground truth for the performance evaluation testing in pig eyes. The assessment of whether the device "meets all performance specification requirements" would likely be based on objective measurements (e.g., flap thickness, diameter, smoothness) rather than expert opinion on clinical outcome, as it's an animal model.

4. Adjudication Method for the Test Set

Not applicable. The performance evaluation described is technical testing in an animal model, not interpretative assessment by experts requiring adjudication.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This type of study is relevant for diagnostic imaging devices where human readers interpret results, often with and without AI assistance. The VISITOME 20-10 Microkeratome is a surgical instrument, and its evaluation focuses on mechanical performance and safety, not diagnostic interpretive accuracy.

6. Standalone (Algorithm Only) Performance

Not applicable. As a surgical microkeratome, the device does not have an "algorithm only" performance component in the sense of an AI diagnostic tool. Its performance is entirely mechanical and involves human operation.

7. Type of Ground Truth Used for the Test Set

The ground truth for the performance evaluation testing in pig eyes would be objective measurements of the corneal flaps created, such as:

  • Flap thickness
  • Flap diameter
  • Flap morphology/smoothness
  • Integrity of the corneal bed
  • Blade performance (e.g., sharpness after use)

This is a form of objective measurement against pre-defined specifications, rather than expert consensus, pathology, or outcomes data in humans.

8. Sample Size for the Training Set

Not applicable. The VISITOME 20-10 Microkeratome is a mechanical surgical device and does not involve machine learning or an "algorithm" in the sense that would require a training set. The device's design and engineering principles are based on established biomechanical and optical principles, not data-driven learning.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as there is no training set for this type of mechanical device.

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KO14000

510(k) SUMMARY VISITOME 20-10 MICROKERATOME

1. SUBMITTER INFORMATION

MAR 1 1 2002

A.Company Name:Biovision AG
B.Company Address:60 EigerstrasseBern, Switzerland CH-3007
C.Company Phone:Company Fax:031-372-4404031-372-4412
D.Contact Person:Edmond BaumgartnerGeneral ManagerBiovision AG
E.Date Summary Prepared:November 26, 2001

2. DEVICE IDENTIFICATION

A.Classification Name:Keratome, AC-Powered
B.Trade/Proprietary Name:Visitome 20-10 Microkeratome
C.Classification:Class I (886.4370)
D.Product Code:86 HNO

DEVICE DESCRIPTION 3.

The Visitome 20-10 Microkeratome is an AC-powered device that is used for making a flap by incising the cornea at a predetermined thickness and diameter using a high-speed oscillating blade made of stainless steel. The device consists of the following main components and accessories: the control unit, a surgical unit (handpiece with drive assembly, positioning ring assembly, applanator assembly, and a stainless steel blade holder), a foot pedal, tubing kit (accessory), and a fluid collection container (accessory).

Image /page/0/Picture/10 description: The image shows a circle with the text "DMC" written inside it. Below the text, the number "3/14" is written. The circle appears to be hand-drawn with a thick marker or pen, and the text is also handwritten.

11/29/01

128

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The Visitome 20-10 Microkeratome contains a positioning ring which allows the cornea to protrude through the ring. The cornea is restrained by an applanation shoe surface, which may be pivoted away. A stainless steel blade is suspended from the end of the positioning ring by a blade support (holder) which is driven by a drive mechanism, so that the blade moves along a forward path between the positioning ring and the applanation shoe while oscillating laterally. Drive control and vacuum for the positioning ring are provided by user command via the control unit and foot pedal.

INTENDED USE 4.

The Visitome 20-10 Microkeratome is intended for use in the making of a corneal flap in patients undergoing LASIK surgery or other treatment requiring initial lamellar resection of the cornea.

ડ. SUBSTANTIAL EQUIVALENCE

The Biovision AG. Visitome 20-10 Microkeratome is equivalent to the following predicate device (predicate device information can be found in Section 10):

PredicateDevice510(K) Owner510(k) No.Date Cleared
HansatomeMicrokeratomeBausch & LombSurgicalK010260April 27, 2001

TECHNOLOGICAL CHARACTERISTICS Q.

A comparison of the technological characteristics of the Visitome 20-10 Microkeratome and the predicate device has been performed, and the results are

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summarized in the table below. The results of this comparison demonstrate that the Visitome 20-10 Microkeratome has the same basic technological characteristics as the predicate device and is equivalent to the marketed predicate device. The differences between the Visitome 20-10 Microkeratome and the predicate device are insignificant and do not affect the safety or effectiveness of the device.

COMPARISON CHART
Biovision AG Visitome 20-10MicrokeratomeHansatome MicrokeratomePredicate Device - K010260
Indications ForUseThe Visitome 20-10Microkeratome is indicated foruse in the making of a cornealflap in patients undergoingLASIK surgery or othertreatment requiring initiallamellar resection of the cornea.The Hansatome Microkeratome is aprecision-manufactured instrumentindicated for use in the making of acorneal flap in patients undergoingLASIK surgery or other treatmentrequiring initial lamellar resectionof the cornea.
OperatingPrincipleElectrically driven oscillatingblade housed in a head whichguides the blade across thecornea on a gear rack. A footpedal with 3 pedal switches isused as the control mechanism.Electrically driven oscillating bladehoused in a head which guides theblade across the cornea on anelevated gear rack. A footswitch(single or dual) is used as thecontrol mechanism.
Type of Hingeor FlapNasal and SuperiorNasal and Superior
COMPARISON CHART
Biovision AG Visitome 20-10MicrokeratomeHansatome MicrokeratomePredicate Device - K010260
Manual orAutomaticBladeAdvancementAutomaticAutomatic
BladeAdvancementRate1 to 10 mm/secUnknown
OscillationRate0 to 12,000 rpmUnknown
Flap DiameterResectionRange of 7.5 to 10.5 mm8.5 & 9.5 mm; accuracy of eachdiameter unknown
Thickness ofResection120, 160 & 180 microns160 & 180 microns
Eye FixationMethodSuction Ring (sizes 10.5, 11.5,& 12.0 mm)Suction Ring (sizes 8.5 & 9.5 mm)
DisposableBlade withFixed Holder?YesYes
Blade Angle32 degrees25 degrees
KeratomeBlade MaterialStainless SteelStainless Steel
HandpieceMaterialTitaniumStainless Steel
ComponentsThat Contactthe PatientBladeSuction RingBladeKeratome HeadSuction Ring
Safety Features1. Internal diagnostics featureensures system integrityprior to each procedure.2. Cutting motion will not startuntil appropriate vacuumlevel is reached.3. If vacuum is lost during the1. Internal diagnostics featureensures system integrity priorto each procedure.2. Cutting motion will not startuntil appropriate vacuum levelis reached.3. Cutting stops if vacuum drops
COMPARISON CHART
Biovision AG Visitome 20-10MicrokeratomeHansatome MicrokeratomePredicate Device - K010260
cut, an alarm will sound andthe low vacuum light willcome on. Cutting will stopautomatically.below threshold.

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·

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PERFORMANCE DATA 7.

The Visitome 20-10 Microkeratome has been designed and will be tested in accordance with applicable electrical safety standards. The device underwent performance evaluation testing in pig eyes to demonstrate that the device meets all performance specification requirements, and is substantially equivalent to the predicate device.

CONCLUSIONS 8.

Biovision AG has demonstrated through its evaluation of the Visitome 20-10 Microkeratome that the device is equivalent to the predicate device with respect to intended use, technological characteristics, and safety and effectiveness.

132 . . . . . . .

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/5/Picture/1 description: The image shows a black and white logo. The logo consists of a stylized bird with three curved lines representing its wings and body. The bird is enclosed within a circle, and the text "HUMAN SERVICES - USA" is written around the circumference of the circle. The text is slightly blurred, and the overall image has a somewhat grainy quality.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 11 2002

Biovision AG c/o Mr. David S. Fernquist Regulatory Affairs Consultant Visitome, Inc. 27 Mauchly, Unit 206 Irvine, CA 92618

Re: K014000

Trade/Device Name: Visitome 20-10 Microkeratome Regulation Number: 21 CFR 886.4370 Regulation Name: Keratome Regulatory Class: Class I Product Code: HNO Dated: February 20, 2002 Received: February 22, 2002

Dear Mr. Fernquist:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2 - Mr. David S. Fernquist

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

A. Ralph Rosenthal

A. Ralph Rosenthal, M.D. Director Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

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INDICATIONS FOR USE

510(k) Number:K014000 (To Be Assigned By FDA)
Device Trade Name:VISITOME 20-10 MICROKERATOME
Indications For Use:The Visitome 20-10 Microkeratome is indicated for use in the making of a corneal flap in patients undergoing LASIK surgery or other treatment requiring initial lamellar resection of the cornea.
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(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office
Division of Ophthalmic Ear, Nose and Throat Devices
Prescription Use
510(k) NumberK014000
OR
Over-The-Counter Use

(Per 21 CFR 801.109)

§ 886.4370 Keratome.

(a)
Identification. A keratome is an AC-powered or battery-powered device intended to shave tissue from sections of the cornea for a lamellar (partial thickness) transplant.(b)
Classification. Class I.