Spotlight ON TECHNOLOGY & TECHNIQUE

Red Reflex Technology Delivers Increased Visual Detail

By Leslie Goldberg, Associate Editor

Carl Zeiss Meditec's (Dublin, Calif.) OPMI Lumera T surgical microscope features a revolutionary red reflex technology, offering physicians the ability to see more contrast, brilliance and stability than ever before.

Instant Red Reflex

Carl Zeiss is the first company to develop surgical microscopes with stereo coaxial illumination. This illumination quality enables physicians to benefit from the unique detail recognition, high-contrast brilliance and stability of the red reflex, even with strongly pigmented, decentered and ametropic eyes.

"We have been using the Lumera since September 2007," says David Chang, M.D., clinical professor of ophthalmology at the University of California, San Francisco. "Operating through the Zeiss Lumera is like watching high-definition television for the first time. A surgeon will be immediately impressed by seeing more detail than he or she previously did through other microscopes. The enhanced red reflex is most helpful for seeing microscopic details of the anterior and posterior capsule, the cortex, the endothelial surface and the anterior vitreous."

By positioning the OPMI Lumera T surgical microscope over the patient's eye and turning on the light, the eye illuminates brightly, as if the user had just turned on a lamp, even with more mature cataracts.

"As we know from our slit lamps, coaxial illumination (zero degree offset) produces the brightest red reflex," says Dr. Chang. "The problem with a zero-degree illumination angle is the loss of depth, and for this reason, a slight two-degree illumination angle offset is used in the traditional surgical microscope.

Lumera's Advances

Dr. Chang says that Zeiss has engineered two significant technological advances into the Lumera viewing system. "First, the primary illumination beam is split into two beams that separately follow the optical path of each individual ocular. This maximizes coaxial illumination and produces a brilliantly intense red reflex."

"Second," says Dr. Chang, "the optics have been re-engineered to provide better contrast, which maintains and improves the depth perception ordinarily lost with purely coaxial illumination."

The final feature is the option of a xenon light source, says Dr. Chang. He explains that this produces a whiter, cooler illumination, in contrast to the "yellower" tone of the traditional halogen bulb.

"This further accentuates the contrast of the red reflex. The latter practically glows, as though there is a tiny light bulb inside the vitreous cavity. When I first started using the Lumera, I began calling this a "jack-o-lantern" red reflex," says Dr. Chang.

Dr. Chang says that a brighter red reflex is advantageous for small pupil cases or in situations where corneal visibility is impaired. Examples of this would be corneal stromal scarring or dystrophies.

"Seeing greater capsular detail such as folds or debris is particularly important in complicated cases, such as those with weakened or deficient zonules," says Dr. Chang.

Additional Features

The integrated Superlux Eye xenon illumination allows users to see the anatomic structure of the eye in its natural colors and highly accurate detail. The use of the HaMode filter enables surgeons who prefer halogen to quickly switch to a light spectrum equivalent to halogen. This is particularly beneficial when several surgeons with different preferences regarding the light source use one system.

An integrated DeepView depth-of-field management system allows users to choose between maximum depth of field or optimum light transmission at the push of a button. In addition, if the system is equipped with halogen illumination, it will automatically switch to the backup bulb if necessary. Surgery no longer needs to be interrupted when a bulb goes out.

It is possible to equip the floor stand for the OPMI Lumera T surgical microscope with an integrated video monitor. The monitor can be placed in various positions, enabling the entire OR staff to follow the operation.

All illumination settings are configured on one control element, which can be easily reached on the microscope. SCI is intuitive and easy to understand.

The Lumera can also be equipped with a completely integrated assistant's microscope. The second surgeon selects the focus and magnification independently of the main surgeon, thus enabling active assistance. The assistant enjoys full 3-D quality without limiting the light of the main surgeon.

Effortless Positioning

Magnetic brakes make positioning the surgical microscope simple. When the brakes are released, the system smoothly glides into a new position; when locked, the microscope remains firmly in place. The brakes for the X, Y and Z directions can be released separately, providing users with more comfort for minor positioning changes. OM

For more information, visit the Lumera Web site at www.zeiss.com/lumera or call (800) 442-4020.