To Loupe or Not To Loupe? That is the Question!

Is magnification really, really necessary for successful strabismus surgery? May be not….. Does magnification benefit the surgeon who performs strabismus surgery? Yes!!

Advantages of Magnification

The surgeon sees the anatomy in more detail in the operative field – enabling more focused attention to finer detail – and contributing to:

• Accurate suture placement
• Awareness of small vessels making it easier to control bleeding
• Accurate identification of tissue layers
• Better visualization of sutures and needles
• Accurate needle placement, enabling a shallow “scleral tunnel” – avoiding scleral perforation

Methods to Achieve Magnification with Loupes

• Power 2.5x to 4.5x (2.5 okay for “younger eyes” but eventually 3.5x to 4.0x is the choice for older surgeons)
• Working Distance + 16″
• A light mounted on a head band and placed between the eyepieces of the loupe is an option many surgeons prefer – this light is especially useful for working in a “hole” such as when doing orbit surgery.

Types of Loupes

• A headband mounted light is a very useful adjunct to loupe magnification in that it improves the view when working in a “hole” and in cases where the surgeon’s or the assistant’s head blocks the fixed operating lights.
• Spectacle mounted loupes are the most popular. They should include distance correction and may have a small bifocal add.
• Presbyopic surgeons benefit from a small bifocal to see at near when looking around loupes
• Head band mounted loupes may be used while the surgeon wears spectacles. They may also be used by several different surgeons. Most surgeons who use loupes purchase the spectacle mounted type.

Want to know more or order magnification loupes? Contact AdmetecVision at www.admetec-vision.com, or call us at our toll-free number: 1-888-670-5063. Prefer to email? You can reach us at contact@admetec-vision.com.

Ready to make your purchase? You can order now online!

(Image courtesy of Wikipedia)

Why Loupes are a wise long-term investment

Since the 1980s, TV series such as Chicago Hope, Grey’s Anatomy, ER, and House M.D. have been featuring surgeons operating while wearing loupes. It makes the show look authentic and the doctors in it as highly regarded professionals. They use of the best equipment available in order to provide excellent care to their patients.

When it is time to buy loupes, an appealing frame looks is part of it. But the major consideration is how the optical equipment will perform and how will it stand up to everyday use.

The two most common types of loupe configurations available are flip-up and through-the-lens (TTL). Through-the-lens optics are customized to meet the clinician’s individual needs. They are permanently glued in place. The main advantages of using TTL loupes (compared to flip-ups) are:

1. The optics stay aligned
2. They are well-balanced
3. They are light-weight
4. They provide a wider field of vision (the optics are close to the eyes)

The TTL setup is similar to top-lined reading glasses where the wearer looks over the optic to view the room using distance vision and though the optic when viewing the patient’s mouth at close range.

Flip-up telescopes are adjustable. Some clinicians with strong prescriptions or bifocals therefore prefer flip-up telescopes because the optics can be flipped up and out of the way. When wearing flip-up telescopes, it is advised to use a head strap that is fastened securely around the wearer’s head. Flip-up loupes are adjustable and can be changed to different frames if wanted. It is easy to change a prescription in a flip-up loupe if the vision of the clinician changes.

Choosing a lower magnification level offers a wider field of vision and a more forgiving depth of field when looking through the optic area than higher magnification. Stronger telescopes zoom in to a narrow field and are difficult to work with independently.

When choosing optics make sure your loupes are:  light-weight, have a wide field of vision, have three-dimensional image qualities,and have very sharp high-resolution image. For these reasons, Admetec-Vision is often the preferred choice.

Good frames are made of titanium to pass the test of time and to ensure daily use. The purchase of a loupe is a long-term investment. It is important to buy a quality product that will stand up to daily use to prevent the need to repurchase in a short period of time.

Editorial note: The full  article was originally published in Hygiene Tribune US, Vol. 2, Issue 1, 2009.

AdmetecVision Salutes David C. Knight M.D. on being named Humanitarian of the Year

David C. Knight, MD, a general surgeon who has practiced at Waterbury Hospital for more than 25 years, has been named the hospital’s “2011 Humanitarian of the Year” for his work bringing medical supplies and expertise to underdeveloped countries across the globe.

Knight, who is the Associate Program Director of Waterbury Hospital’s General Surgery Residency Program, has helped save countless lives over the past several years through a non-profit organization he founded that provides much-needed surgical “loupes” to surgeons in Third World countries. Loupes, which are commonplace in the U.S. and other developed nations, are high-tech optical glasses that allow surgeons to identify and focus on minute details during the course of a procedure.

In 2006, while touring hospitals and medical clinics in Vietnam and Cambodia, Knight developed a friendship with a Cambodian plastic surgeon who told him he routinely conducted procedures without the assistance of loupes. The encounter prompted Knight to form Loupes Around the World, an organization that works to raise donations to provide loupes to surgeons in Third World countries. Since then, the organization has provided 182 loupes to surgeons in more than 42 countries.

Besides his work raising money for loupes, Knight has also taken part in several humanitarian missions to the African nation of Liberia, which is recovering from a recent civil war that decimated much of its medical infrastructure. Before the war, the country had over 400 physicians treating a population of over 3.5 million; after the war, there were only 50 physicians remaining, six of them surgeons. Knight has conducted four missions to the country, providing badly needed assistance and teaching to Liberian physicians working in the country’s largest hospital in the capital of Monrovia.

Knight will be recognized during the hospital’s 12^th Annual Charity Gala on Saturday, November 19 at the Villa Rosa (Ponte Club)

(Credit Ronald DeRosa)

Ophthalmic Microsurgery with Surgical Loupes

Ophthalmologists are micro surgeons, trained to operate with precise control and meticulous detail on one of the smallest organs in the body. They therefore rely on a variety of magnification instruments to operate. Many external, oculoplastics and pediatric procedures can also be performed with high quality surgical loupes.

Surgeons from a wide range of microsurgical subspecialties use surgical loupes on a routine basis in their practices. Loupes can provide up to six times magnification compared with operating microscopes, which provide up to 40 times magnification. While operating microscopes are usually necessary when performing procedures on structures that are less than 1-2 mm, loupes are less expensive, easier to use, and mobile alternatives for procedures requiring less magnification. Amongst the range of surgical sub specialists, Ophthalmologists depend relatively heavily on operating microscopes and surgical loupes.

Several factors should be taken into consideration when purchasing surgical loupes.

Resolution
Resolution depends on the design and quality of the lenses used in the loupes. It is the primary factor in determining the overall quality of the loupe. Lenses used by Admetec-Vision provide excellent resolution.

Width of the loupe field
Ophthalmic surgeons normally prefer a large field-width, since a wider loupe field allows the surgeons to keep their instruments in perspective with the area of focus. The width of the field is also determined in part by the design and quality of the optics.

Magnifying power
Ophthalmic surgeons usually prefer loupes magnifying between 2.5X to 4X. Some procedures require more magnification than others, and a surgeon performing oculoplastics procedures may require loupes with different magnification compared with those surgeons performing pediatric strabismus procedures or scleral buckles.

Depth of field
An important factor the loupe’s depth of field. The field depth is a measure of the loupe’s capacity to focus across a given distance.

Other factors
Other factors in selecting surgical loupes are the weight of the instrument and the working angle of the loupes. Most surgeons prefer lighter frames to minimize strain.

Working angle
This optical declination angle is the angle to which the surgeons lower their eyes in order to obtain the optimal working position through the loupes. Most surgeons measure their angle by sitting in their optimal working position with their eyes closed, then opening their eyes to ensure that their loupes match their working angle.