New system for fiberoptic-free bimanual vitreous surgery

Objectives: To describe a new system for fiberopticfree bimanual vitrectomy and to present the outcome of 37 eyes with preretinal membranes due to diabetic retinopathy or proliferative vitreoretinopathy that underwent surgery using this system. Methods: The system consists of a 40-diopter aspheric field lens suspended from the operating microscope and a prismatic inverting device. The aspheric lens is placed above the cornea, and the illumination from the operating microscope creates an inverted image of the fundus, which is made erect by an inverter system. No fiberoptics are required, and both hands are free to use 2 microinstruments. Main Outcome Measures: The practical utility of this system and its surgical results and complications. Results: The system was used successfully in all cases. Membrane dissection and hemostasis were performed without incident. An improvement in visual acuity of 2 or more lines was found in 30 of 37 eyes. Five eyes did not reveal change of 2 or more lines, and 2 eyes had a decrease in visual acuity of more than 2 lines. There was no evidence of phototoxicity. Conclusion: This system is very useful for bimanual vitrectomy.