VOL. 81, NO. 1
NOTES, CASES, INSTRUMENTS
99
SUMMARY
A conic tube may be adjusted by varying the distal diameter and by using binocular vision for measuring distances. This device appears to be the earliest telemeter in the world. It is mentioned in the Talmud as being used in the first century A.D. Fig
REFERENCE
·
1
(P e y m a n )·
Tne
vitrophage equipped with
fiberoptic illumination. Inset, The disconnected 1. Bar-Ilan, M., and Zevin, S. I. : Talmudic fiberoptic cord. Encyclopedia. Jerusalem, Talmudic Encyclopedia Publisher, 1949, pp. 28-29.
IMPROVED VITRECTOMY I L L U M I N A T I O N SYSTEM GHOLAM A. PEYMAN,
M.D.
Chicago, Illinois Although vitrectomy can be performed under visualization of the fundus with the light source of the operating microscope,1-5 many vitrectomy instruments 6-9 are presently equipped with a fiberoptic light guide. How ever, the advantage of a reflex-free operation must be weighed against the shortcomings of the fiberoptic light guides. The light pipes presently available for use in vitrectomy have one major disadvantage. The tip of the fiberoptic sleeve builds a shoulder on the vitrectomy instrument. As a result, the choroid or the retina can be pushed away when the light pipe and vitrectomy instrument are inserted inside the vitreous body, thus caus ing dialysis. An additional disadvantage of this light pipe is that there is always a po tential space between the instrument's tip and the light guide. Vitreous humor can intrude and catch in this space; thus, when this instrument is removed vitreous traction can tear the retina. Because of these potential hazards, we have only infrequently used the From the University of Illinois Eye and Ear In firmary, Chicago, Illinois. This study was supported by Public Health Service grant 1107-03, and in part by the Illinois Lions Club, Chicago. Reprint requests to Gholam A. Peyman, M.D., University of Illinois Eye and Ear Infirmary, 1855 W. Taylor St., Chicago, IL 60612.
Fig. 2 (Peyman). Magnified view of the vitro phage tip showing the tapered shoulder of the fiberoptic sleeve (arrow).
fiberoptic source available for vitrectomy. To overcome these problems we have designed a new fiberoptic light guide.* The original light pipe9 is now perma nently mounted on the vitrophage. A joint permits disconnection of this fiberoptic from the cord and original light source (Fig. 1). In addition, the shoulder of the light pipe is tapered with epoxy and glued to the vitro phage tip (Fig. 2 ) . The prototype eliminates immediately the hazards of inserting the vitrectomy instru ment into the eye. Despite the joint locks we have enough light inside the eye to perform vitrectomy, and visualization is good. SUMMARY
To facilitate insertion of a fiberoptic light source inside the vitreous body, we developed a prototype fiberoptic light guide. The light pipes are permanently mounted on the vitro phage and the front ends are tapered. REFERENCES
1. Machemer, R., Buettner, H., Norton, E. W. D., and Parel, J.-M.: Vitrectomy. A pars plana ap* The David Kopf Co. and Electrofiberoptic Co. constructed the prototype.
100
AMERICAN JOURNAL OF OPHTHALMOLOGY
proach. Trans. Am. Acad. Ophthalmol. Otolaryngol. 75:812, 1971. 2. Peyman, G. A., and Dodich, N. A.: Experi mental vitrectomy, instrumentation and surgical technique. Arch. Ophthalmol. 86:548, 1971. 3. Peyman, G. A., Ericson, E. S., and May, D. R. : Slit illumination system and contact lens support ring for use with operation microscope. Ophthalmic Surg. 3:29, 1972. 4. Parel, J.-M., Machemer, R., and Aumayr, W. : A new concept for vitreous surgery. Improvement in instrumentation and illumination. Am. J. Oph thalmol. 77:6, 1974. 5. Peyman, G. A., and Urban, J.: A new op erating microscope for extraocular and intraocular surgery. Am. J. Ophthalmol. 77:525, 1974. 6. Douvas, N. G. : The cataract roto-extractor. A preliminary report. Trans. Am. Acad. Ophthal mol. Otolaryngol. 77:792, 1973. 7. Kloti, R. : Vitrectomy. 1. A new instrument in pars plana approach vitrectomy. Albrecht von Graefe's Arch. Klin. Ophthalmol. 189:125, 1973. 8. Kreiger, A. E., Straatsma, B. R., Storm, F. K., and Smiley, E. H. : A vitrectomy instrument in stereotaxic intraocular surgery. Am. J. Ophthalmol. 76:527, 1973. 9. Peyman, G. A., and Huamonte, F. U. : A dis posable vitrectomy instrument. The vitrophage. Can. J. Ophthalmol. 10:281, 1975.
GIANT D R U S E N (ASTROCYTIC HAMARTOMA) O F T H E OPTIC NERVE SEEN WITH COMPUTERIZED A X I A L TOMOGRAPHY MARK J. DAILY, M.D., M.D.,
JANUARY, 1976
C A S E REPORT
A 75-year-old white man was seen in 1963 for examination of the optic disks. Best corrected visual acuity was R.E.: 20/20, and L.E.: 20/15. Visual field examination showed a lower nasal field defect in the left eye. Ophthalmoscopic examination of the right eye was normal but examination of the left eye revealed giant drusen of the optic disk (Fig. 1). A neurologic examination was normal. The pa tient was seen again in 1973, and visual acuity was R.E.: 20/20, and L.E. : 20/50. The visual fields and
Fig. 1 (Daily, Smith, and Dickens). Giant drusen (astrocytic hamartoma) of the left optic disk in 1963.
J. LAWTON S M I T H ,
AND W I L L I S DICKENS,
M.D.
Miami, Florida The EMI computerized axial tomography is a safe, noninvasive method for evaluation of soft tissue abnormalities in previously inaccessable areas and can be highly specific. Wright, Lloyd, and Ambrose 1 have docu mented its accuracy in defining optic nerve abnormalities. This presentation is the first documentation, to our knowledge, of giant optic nerve drusen (astrocytic hamartoma) by EMI scan. From the Bascom Palmer Eye Institute, Depart ment of Ophthalmology, University of Miami School of Medicine, Miami, Florida. Reprint requests to J. Lawton Smith, M.D., 1638 N.W. 10th Ave., Miami, FL 33136.
Fig. 2 (Daily, Smith, and Dickens). EMI scan in 1975 shows giant drusen in left optic nerve.
NOTES, CASES, INSTRUMENTS
99
SUMMARY
A conic tube may be adjusted by varying the distal diameter and by using binocular vision for measuring distances. This device appears to be the earliest telemeter in the world. It is mentioned in the Talmud as being used in the first century A.D. Fig
REFERENCE
·
1
(P e y m a n )·
Tne
vitrophage equipped with
fiberoptic illumination. Inset, The disconnected 1. Bar-Ilan, M., and Zevin, S. I. : Talmudic fiberoptic cord. Encyclopedia. Jerusalem, Talmudic Encyclopedia Publisher, 1949, pp. 28-29.
IMPROVED VITRECTOMY I L L U M I N A T I O N SYSTEM GHOLAM A. PEYMAN,
M.D.
Chicago, Illinois Although vitrectomy can be performed under visualization of the fundus with the light source of the operating microscope,1-5 many vitrectomy instruments 6-9 are presently equipped with a fiberoptic light guide. How ever, the advantage of a reflex-free operation must be weighed against the shortcomings of the fiberoptic light guides. The light pipes presently available for use in vitrectomy have one major disadvantage. The tip of the fiberoptic sleeve builds a shoulder on the vitrectomy instrument. As a result, the choroid or the retina can be pushed away when the light pipe and vitrectomy instrument are inserted inside the vitreous body, thus caus ing dialysis. An additional disadvantage of this light pipe is that there is always a po tential space between the instrument's tip and the light guide. Vitreous humor can intrude and catch in this space; thus, when this instrument is removed vitreous traction can tear the retina. Because of these potential hazards, we have only infrequently used the From the University of Illinois Eye and Ear In firmary, Chicago, Illinois. This study was supported by Public Health Service grant 1107-03, and in part by the Illinois Lions Club, Chicago. Reprint requests to Gholam A. Peyman, M.D., University of Illinois Eye and Ear Infirmary, 1855 W. Taylor St., Chicago, IL 60612.
Fig. 2 (Peyman). Magnified view of the vitro phage tip showing the tapered shoulder of the fiberoptic sleeve (arrow).
fiberoptic source available for vitrectomy. To overcome these problems we have designed a new fiberoptic light guide.* The original light pipe9 is now perma nently mounted on the vitrophage. A joint permits disconnection of this fiberoptic from the cord and original light source (Fig. 1). In addition, the shoulder of the light pipe is tapered with epoxy and glued to the vitro phage tip (Fig. 2 ) . The prototype eliminates immediately the hazards of inserting the vitrectomy instru ment into the eye. Despite the joint locks we have enough light inside the eye to perform vitrectomy, and visualization is good. SUMMARY
To facilitate insertion of a fiberoptic light source inside the vitreous body, we developed a prototype fiberoptic light guide. The light pipes are permanently mounted on the vitro phage and the front ends are tapered. REFERENCES
1. Machemer, R., Buettner, H., Norton, E. W. D., and Parel, J.-M.: Vitrectomy. A pars plana ap* The David Kopf Co. and Electrofiberoptic Co. constructed the prototype.
100
AMERICAN JOURNAL OF OPHTHALMOLOGY
proach. Trans. Am. Acad. Ophthalmol. Otolaryngol. 75:812, 1971. 2. Peyman, G. A., and Dodich, N. A.: Experi mental vitrectomy, instrumentation and surgical technique. Arch. Ophthalmol. 86:548, 1971. 3. Peyman, G. A., Ericson, E. S., and May, D. R. : Slit illumination system and contact lens support ring for use with operation microscope. Ophthalmic Surg. 3:29, 1972. 4. Parel, J.-M., Machemer, R., and Aumayr, W. : A new concept for vitreous surgery. Improvement in instrumentation and illumination. Am. J. Oph thalmol. 77:6, 1974. 5. Peyman, G. A., and Urban, J.: A new op erating microscope for extraocular and intraocular surgery. Am. J. Ophthalmol. 77:525, 1974. 6. Douvas, N. G. : The cataract roto-extractor. A preliminary report. Trans. Am. Acad. Ophthal mol. Otolaryngol. 77:792, 1973. 7. Kloti, R. : Vitrectomy. 1. A new instrument in pars plana approach vitrectomy. Albrecht von Graefe's Arch. Klin. Ophthalmol. 189:125, 1973. 8. Kreiger, A. E., Straatsma, B. R., Storm, F. K., and Smiley, E. H. : A vitrectomy instrument in stereotaxic intraocular surgery. Am. J. Ophthalmol. 76:527, 1973. 9. Peyman, G. A., and Huamonte, F. U. : A dis posable vitrectomy instrument. The vitrophage. Can. J. Ophthalmol. 10:281, 1975.
GIANT D R U S E N (ASTROCYTIC HAMARTOMA) O F T H E OPTIC NERVE SEEN WITH COMPUTERIZED A X I A L TOMOGRAPHY MARK J. DAILY, M.D., M.D.,
JANUARY, 1976
C A S E REPORT
A 75-year-old white man was seen in 1963 for examination of the optic disks. Best corrected visual acuity was R.E.: 20/20, and L.E.: 20/15. Visual field examination showed a lower nasal field defect in the left eye. Ophthalmoscopic examination of the right eye was normal but examination of the left eye revealed giant drusen of the optic disk (Fig. 1). A neurologic examination was normal. The pa tient was seen again in 1973, and visual acuity was R.E.: 20/20, and L.E. : 20/50. The visual fields and
Fig. 1 (Daily, Smith, and Dickens). Giant drusen (astrocytic hamartoma) of the left optic disk in 1963.
J. LAWTON S M I T H ,
AND W I L L I S DICKENS,
M.D.
Miami, Florida The EMI computerized axial tomography is a safe, noninvasive method for evaluation of soft tissue abnormalities in previously inaccessable areas and can be highly specific. Wright, Lloyd, and Ambrose 1 have docu mented its accuracy in defining optic nerve abnormalities. This presentation is the first documentation, to our knowledge, of giant optic nerve drusen (astrocytic hamartoma) by EMI scan. From the Bascom Palmer Eye Institute, Depart ment of Ophthalmology, University of Miami School of Medicine, Miami, Florida. Reprint requests to J. Lawton Smith, M.D., 1638 N.W. 10th Ave., Miami, FL 33136.
Fig. 2 (Daily, Smith, and Dickens). EMI scan in 1975 shows giant drusen in left optic nerve.
