96th DOG Annual Meeting, 1998



F. Koch, H. G├╝mbel, A. Augustin

Most procedures in the vitreous cavity are performed under the microscope and have their limitations in diagnosis and treatment anterior to the equator, in the subretinal space and in high resolution imaging.

Endoscope: A rigid endoscope with 20 gauge outer diameter, a 90 gram handpiece and gradient index (GRIN) lens transfer optics (1), one channel for infusion and one working channel e.g. for laser coagulation delivers a resolution which is significantly superior to the resolution of any fiberoptic bundle endoscope and can be achieved even at a 0- distance between object and endoscope tip.

Indications: High resolution viewing of 1. The ora serrata/pars plana and structures related to this area: sclerotomies with or without cannula protection, drug delivery devices sutured in the pars plana, and peripheral vascular proliferations. 2. Delicate membranes in a macula pucker or macula hole situation. 3. The transretinal surgical access to the subretinal space with optical control of adhesions between membranes, pigment epithelium and sensory retina during extraction of subretinal membranes.

Conclusion: Due to the small distance and high optical resolution of the GRIN-microendoscope which allows to visualize erythrocytes in retinal and choroidal vessels we can add a variety of new diagnostic and therapeutic steps to the spectrum of vitreoretinal surgery.

1. P.Rol, R Jenny, D.Beck, F. Fankhauser, P.F. Niederer: Optical properties of miniaturized endoscopes for ophthalmic use. Opt. Eng. 34 (1995) 2070-2077

University Eye Clinic, Theodor-Stern-Kai 7, D-60590 Frankfurt a.M.