Abstract
Abstract: :
Purpose: To improve a non-contact wide-field viewing system recently described by Landers et al consisting of a hinged, adjustable arm and a 132-diopter condensing lens alone or with a reinverting prism. This lens system, which is less expensive than others offering the same viewing characteristics, has been used in more than 100 vitrectomies in five major medical centers around the world, and has been proven to provide an excellent view of the retina and vitreous. Its chief disadvantage is the attachment of the lens to the wrist rest or the operating table; given the constant refocusing and manipulation required in vitreoretinal surgery, the static position of the lens on the wrist rest requires constant refocusing and centering maneuvers. The weak magnification limits its use in macular surgery. Methods: We have developed a new attachment and, in conjunction with Ocular Instruments Inc. (Bellevue, WA), a new magnifying lens. The attachment consists of an adjustable arm piece attached to the microscope. The arm piece has several segments connected through joints that allow the arm piece to reach the desired location unobtrusively. Results: Because the lens now moves with the microscope, maneuvers to center the lens over the pupil in the correct three-dimensional location are eliminated. This new position for the lens attachment allows fine focusing using the microscope pedal in contrast to the more cumbersome manipulation required on the BIOM system. The magnifying lens provides sufficient magnification for epiretinal or inner limiting membrane peeling. Conclusions: The adjustable arm piece attached to the microscope of the non-contact wide-field viewing system requires less refocusing and centering of the lens over the pupil and allows fine focusing to be performed using the microscope pedal. The magnifying lens also permits increased magnification for macular surgery.
Keywords: vitreoretinal surgery • retina