Settings, Techniques, and Technologies Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
Wide-Angle Viewing System Makoto Inoue Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan
A wide-angle viewing system offers a panoramic view of the surgical field and also improves the safety and efficacy of the vitreoretinal surgical procedure. Surgeons can easily observe the fundus in almost the whole area and evaluate the retinal pathologies through the panoramic view even in eyes with small pupils, corneal opacity, or eyes implanted with multifocal intraocular lens or toric intraocular lens. Recent wide-angle viewing systems consist of two types: contact lens and non-contact lens. The benefit of the contact lens type is better resolution and contrast of the fundus image compared to the non-contact lens type. The contact lens is directly attached to the cornea and the aberration and the reflection from the corneal surface are canceled. However, the eye position needs to be fixed and surgical procedures that rotate the eye should be avoided because incomplete attachment of the contact lens causes decreased visibility of the fundus image. The benefit of the non-contact lens type is that the viewing angle can be changed by moving the front lens up and down to adjust the distance between the cornea and the front lens. The surgical procedures are more flexible and the eye can be rotated. Dehydration of the corneal surface decreases the visibility of the fundus
image and the corneal surface needs to be covered with viscoelastic material to avoid dehydration. Condensation of the front lens also decreases the visibility of fundus. Understanding the optical characteristics of the wide-angle viewing system is the key to a successful vitreoretinal surgery. © 2014 S. Karger AG, Basel
A wide-angle viewing system offers a panoramic view of the surgical field and also improves the safety and efficacy of vitreoretinal surgical procedures [1]. Surgeons can easily observe the fundus in almost the whole area and evaluate the retinal pathologies through the panoramic view even in eyes with small pupils, corneal opacity, or eyes implanted with multifocal intraocular lens or toric intraocular lens [2, 3]. The peripheral retina can be observed at a glance without rotating the eye excessively and depressing the sclera as with conventional floating prism contact lenses. This wide-angle viewing system is extremely useful especially for retinal detachment associated with giant breaks because the edges of the retinal break can be seen in one view (fig. 1). In conjunction
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
Abstract
with chandelier illumination, a bimanual technique allows a wide area, including the peripheral retina, to be observed without rotating the eye, and thus creation of peripheral retinal breaks can be avoided (fig. 2). Chandelier illumination or slit-lamp illumination built in the microscope in conjunction with a wide-angle viewing system provides wide, excellent visibility of the funduscopic images for scleral buckling procedures without wearing indirect binocular ophthalmoscopy [4]. Adjusting the viewing focus and magnification under the surgical microscope may be more helpful for identifying small tears during surgery which were unrecognized preoperatively. A wide-angle viewing system and chandelier illumination also contributes to expanded use of small-gauge vitrectomy for various vitreoretinal pathologies. Understanding recent developments and optical characteristics of a wide-angle viewing system are essential for achieving successful vitreoretinal surgery.
Fig. 1. Intraoperative wide-angle view of an eye with giant break retinal detachment. Wide-angle viewing with the RESIGHT system enables the visualization of the detached retina to the edge of the retinal break with a conventional light pipe when the perfluorocarbon liquid is injected.
History of the Wide-Angle Viewing System
88
Fig. 2. Bimanual technique with a wide-angle viewing system for proliferative diabetic retinopathy. The peripheral retina is avoided tracting when the fibrovascular membrane is held by forceps and dissected with scissors.
The contact lens-type wide-angle viewing system, which enables better resolution of fundus images, was also introduced during this period [8, 9]. An optical fiber-free intravitreal surgery system (OFFISS), which was initially introduced for
Inoue Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
Dominguez [5] introduced an observation system in which a front lens was used with slit-lamp examination to observe the fundus in the operating microscope in 1981; however, the image was inverted and not widely used. Spitznas and Reiner [6] invented the stereoscopic diagonal inverter, which is attached to a microscope and converts the inverted image through the front lens for wide-angle viewing. Spitznas [7] also introduced a non-contact wide-angle viewing system, the Binocular Indirect Ophthalmo Microscope (BIOM), which consists of a non-contact front lens, reduction lens, and stereoscopic inverter. EIBOS was introduced in 1993 and this system was integrated with a stereoscopic inverter and front lens with manual focusing. The PeymanWessels-Landers 132D upright vitrectomy lens was introduced in 1990, and is also an integrated system of a front lens and stereoscopic inverter.
Fig. 3. Contact lens-type wide-angle viewing system. MiniQuad (ACS) has a stabilizer to stand on the cornea without holding. The height of the Panora View lens is designed to be lower for better stabilization. ACS = Autoclave sterilization lens.
MiniQuad
MiniQuad XL
ClarVit wide angle
MiniQuad (ACS)
Panorama view
Table 1. Catalog data of contact lens-type wide-angle viewing systems
MiniQuad MiniQuad XL ClariVit wide angle Panora View
Magnification
Viewing angle1 (straight/tilting)
Diameter of the lens (up/bottom), mm
Height, mm
156 156 156 128
0.39× 0.39× 0.39× 0.47×
106/127 112/134 110/132 110/132
18.4/11.45 21.4/11.45 0.19/10 16.6/11.2
11.9 13.3 10.6 8.2
The parameters differ in a measuring condition.
vitreous surgery without endoillumination for complicated bimanual surgery, provided a wideangle front lens [10]. This system enables electric control of focusing, magnifying, and the observation angle, and X-Y moving is automatically reversed when the front lens is used. The front lens of OFFISS was attached to the frame of the microscope, not to the main body, to enable focusing with the foot pedal by moving the main body of the microscope up and down and maintaining the distance between the front lens and the cornea. The RESIGHT system has an inner focusing system by moving the reduction lens up and down. This system does not require moving the main body of the microscope upward to make it focused for wide-angle viewing, and the surgery can be seamlessly switched between conventional viewing through the contact lens and wide-angle viewing.
Contact Lens-Type Wide-Angle Viewing System
The benefit of a contact lens-type wide-angle viewing system is the ability to achieve better resolution and contrast of the fundus image compared to the non-contact lens-type wideangle viewing system (fig. 3, table 1). The contact lens is directly attached to the cornea and the aberration of the cornea and the reflection from the corneal surface are canceled. The surgeons do not have to worry excessively about dehydration of the corneal surface. However, the eye position needs to be fixed and the surgical procedures for the peripheral retina involving rotating the eye should be avoided because incomplete attachment of the contact lens causes decreased visibility of the fundus image. The contact lens needs to be held by a skilled assis-
Wide-Angle Viewing System Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
89
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
1
Refractive powers, D
Fig. 4. Non-contact lens-type wideangle viewing system. The field of view and the focus can be adjusted by moving the front lens and the cornea or the reduction lens.
Peyman-Wessels-Landers
tant to keep the contact lens stable and perfectly upright. When using chandelier illumination, the surgeon can hold the contact lens instead of a light guide. The surgeon performs the operation with one hand, and can use the other hand to switch the chandelier light to another sclerotomy port. Another benefit of the contact lens-type wideangle viewing system is less cost compared to the non-contact lens-type wide-angle viewing system. A stereo-converter is required for the surgery, but the cost is almost reduced by half. Non-Contact Lens-Type Wide-Angle Viewing System
The benefit of non-contact lens is the ability to change the viewing angle by moving the front lens up and down and adjusting the distance between
90
RESIGHT
OFFISS
EIBOS, RUV800
the cornea and the front lens (fig. 4, table 2). When the eye is rotated to view the more peripheral areas of the retina, better visibility of the fundus can be achieved with the non-contact lenstype wide-angle viewing system than with the contact lens type. The surgical procedures are more flexible and a skilled assistant to hold the front lens is not required. This is why the noncontact lens-type wide-angle viewing system requires less training time and has a smaller learning curve. Dehydration of the corneal surface decreases the visibility of the fundus image and the corneal surface needs to be covered with viscoelastic material or a hard contact lens should be applied to avoid dehydration. The condensation on the front lens is also a factor that decreases visibility. Draping around the eye must be completely isolated from the breath of the patient to avoid condensation on the front lens.
Inoue Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
BIOM
Table 2. Catalog data of non-contact-type wide-angle viewing systems
BIOM RESIGHT OFFISS MERLIN Landers EIBOS RUV800
Diameter of front lens, mm
Refractive power of front lens, D
Viewing angle
19 17 21 14 18 20 20
132 128 120 140 132 132 132
102.9 94.9 130.2 88.9 99.9 105.8 105.8
Landers = Peyman-Wessels-Landers lens.
Ohji et al. [11] described that a meniscus contact lens combined with a non-contact lens Peyman-Wessels-Landers wide-angle system increased the intraoperative field of view and improved the sharpness of the peripheral images. Ohtsuki et al. [12] described a modified technique
to enhance the visual field through the RESIGHT wide-angle viewing system by applying a magnifying prism meniscus contact lens when the eye is rotated. This technique can eliminate the aberration so as to observe the peripheral retina when rotating the eye.
References 4 Aras C, Ucar D, Koytak A, Yetik H: Scleral buckling with a non-contact wide-angle viewing system. Ophthalmologica 2012;227:107–110. 5 Dominguez A: Oftalmoscopia cinematografica de imagen invertida. Arch Soc Espan Ophthal 1981;41:701–702. 6 Spitznas M, Reiner J: A stereoscopic diagonal inverter (SDI) for wide-angle vitreous surgery. Graefes Arch Clin Exp Ophthalmol 1987;225:9–12. 7 Spitznas M: A binocular indirect ophthalmo microscope (BIOM) for noncontact wide-angle vitreous surgery. Graefes Arch Clin Exp Ophthalmol 1987;225:13–15. 8 Shah VA, Chalam KV: Self-stabilizing wide-angle contact lens for vitreous surgery. Retina 2003;23:667–669.
9 Nakata K, Ohji M, Ikuno Y, et al: Wideangle viewing lens for vitrectomy. Am J Ophthalmol 2004;137:760–762. 10 Horiguchi M, Kojima Y, Shimada Y: New system for fiberoptic-free bimanual vitreous surgery. Arch Ophthalmol 2002;120:491–494. 11 Ohji M, Tada E, Futamura H: Combining a contact lens and wide-angle viewing system for a wider fundus view. Retina 2011;31:1958–1960. 12 Ohtsuki M, Inoue M, Uda S, et al: Combining magnifying prismatic lens with a wide-angle viewing system to enhance view of peripheral retina during vitreous surgery. Retina 2012;32:1983–1987.
Makoto Inoue Kyorin Eye Center, Kyorin University School of Medicine 6-20-2 Shinkawa Mitaka, Tokyo, 181-8611 (Japan) E-Mail [email protected]
Wide-Angle Viewing System Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
91
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
1 Chalam KV, Shah VA: Optics of wideangle panoramic viewing system-assisted vitreous surgery. Surv Ophthalmol 2004;49:437–445. 2 Inoue M, Noda T, Mihashi T, et al: Quality of image of grating target placed in model of human eye with corneal aberrations as observed through multifocal intraocular lenses. Am J Ophthalmol 2011;151:644–652. 3 Inoue M, Noda T, Ohnuma K, et al: Quality of image of grating target placed in model eye and observed through toric intraocular lenses. Am J Ophthalmol 2013;155:243–252.
Wide-Angle Viewing System Makoto Inoue Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan
A wide-angle viewing system offers a panoramic view of the surgical field and also improves the safety and efficacy of the vitreoretinal surgical procedure. Surgeons can easily observe the fundus in almost the whole area and evaluate the retinal pathologies through the panoramic view even in eyes with small pupils, corneal opacity, or eyes implanted with multifocal intraocular lens or toric intraocular lens. Recent wide-angle viewing systems consist of two types: contact lens and non-contact lens. The benefit of the contact lens type is better resolution and contrast of the fundus image compared to the non-contact lens type. The contact lens is directly attached to the cornea and the aberration and the reflection from the corneal surface are canceled. However, the eye position needs to be fixed and surgical procedures that rotate the eye should be avoided because incomplete attachment of the contact lens causes decreased visibility of the fundus image. The benefit of the non-contact lens type is that the viewing angle can be changed by moving the front lens up and down to adjust the distance between the cornea and the front lens. The surgical procedures are more flexible and the eye can be rotated. Dehydration of the corneal surface decreases the visibility of the fundus
image and the corneal surface needs to be covered with viscoelastic material to avoid dehydration. Condensation of the front lens also decreases the visibility of fundus. Understanding the optical characteristics of the wide-angle viewing system is the key to a successful vitreoretinal surgery. © 2014 S. Karger AG, Basel
A wide-angle viewing system offers a panoramic view of the surgical field and also improves the safety and efficacy of vitreoretinal surgical procedures [1]. Surgeons can easily observe the fundus in almost the whole area and evaluate the retinal pathologies through the panoramic view even in eyes with small pupils, corneal opacity, or eyes implanted with multifocal intraocular lens or toric intraocular lens [2, 3]. The peripheral retina can be observed at a glance without rotating the eye excessively and depressing the sclera as with conventional floating prism contact lenses. This wide-angle viewing system is extremely useful especially for retinal detachment associated with giant breaks because the edges of the retinal break can be seen in one view (fig. 1). In conjunction
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
Abstract
with chandelier illumination, a bimanual technique allows a wide area, including the peripheral retina, to be observed without rotating the eye, and thus creation of peripheral retinal breaks can be avoided (fig. 2). Chandelier illumination or slit-lamp illumination built in the microscope in conjunction with a wide-angle viewing system provides wide, excellent visibility of the funduscopic images for scleral buckling procedures without wearing indirect binocular ophthalmoscopy [4]. Adjusting the viewing focus and magnification under the surgical microscope may be more helpful for identifying small tears during surgery which were unrecognized preoperatively. A wide-angle viewing system and chandelier illumination also contributes to expanded use of small-gauge vitrectomy for various vitreoretinal pathologies. Understanding recent developments and optical characteristics of a wide-angle viewing system are essential for achieving successful vitreoretinal surgery.
Fig. 1. Intraoperative wide-angle view of an eye with giant break retinal detachment. Wide-angle viewing with the RESIGHT system enables the visualization of the detached retina to the edge of the retinal break with a conventional light pipe when the perfluorocarbon liquid is injected.
History of the Wide-Angle Viewing System
88
Fig. 2. Bimanual technique with a wide-angle viewing system for proliferative diabetic retinopathy. The peripheral retina is avoided tracting when the fibrovascular membrane is held by forceps and dissected with scissors.
The contact lens-type wide-angle viewing system, which enables better resolution of fundus images, was also introduced during this period [8, 9]. An optical fiber-free intravitreal surgery system (OFFISS), which was initially introduced for
Inoue Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
Dominguez [5] introduced an observation system in which a front lens was used with slit-lamp examination to observe the fundus in the operating microscope in 1981; however, the image was inverted and not widely used. Spitznas and Reiner [6] invented the stereoscopic diagonal inverter, which is attached to a microscope and converts the inverted image through the front lens for wide-angle viewing. Spitznas [7] also introduced a non-contact wide-angle viewing system, the Binocular Indirect Ophthalmo Microscope (BIOM), which consists of a non-contact front lens, reduction lens, and stereoscopic inverter. EIBOS was introduced in 1993 and this system was integrated with a stereoscopic inverter and front lens with manual focusing. The PeymanWessels-Landers 132D upright vitrectomy lens was introduced in 1990, and is also an integrated system of a front lens and stereoscopic inverter.
Fig. 3. Contact lens-type wide-angle viewing system. MiniQuad (ACS) has a stabilizer to stand on the cornea without holding. The height of the Panora View lens is designed to be lower for better stabilization. ACS = Autoclave sterilization lens.
MiniQuad
MiniQuad XL
ClarVit wide angle
MiniQuad (ACS)
Panorama view
Table 1. Catalog data of contact lens-type wide-angle viewing systems
MiniQuad MiniQuad XL ClariVit wide angle Panora View
Magnification
Viewing angle1 (straight/tilting)
Diameter of the lens (up/bottom), mm
Height, mm
156 156 156 128
0.39× 0.39× 0.39× 0.47×
106/127 112/134 110/132 110/132
18.4/11.45 21.4/11.45 0.19/10 16.6/11.2
11.9 13.3 10.6 8.2
The parameters differ in a measuring condition.
vitreous surgery without endoillumination for complicated bimanual surgery, provided a wideangle front lens [10]. This system enables electric control of focusing, magnifying, and the observation angle, and X-Y moving is automatically reversed when the front lens is used. The front lens of OFFISS was attached to the frame of the microscope, not to the main body, to enable focusing with the foot pedal by moving the main body of the microscope up and down and maintaining the distance between the front lens and the cornea. The RESIGHT system has an inner focusing system by moving the reduction lens up and down. This system does not require moving the main body of the microscope upward to make it focused for wide-angle viewing, and the surgery can be seamlessly switched between conventional viewing through the contact lens and wide-angle viewing.
Contact Lens-Type Wide-Angle Viewing System
The benefit of a contact lens-type wide-angle viewing system is the ability to achieve better resolution and contrast of the fundus image compared to the non-contact lens-type wideangle viewing system (fig. 3, table 1). The contact lens is directly attached to the cornea and the aberration of the cornea and the reflection from the corneal surface are canceled. The surgeons do not have to worry excessively about dehydration of the corneal surface. However, the eye position needs to be fixed and the surgical procedures for the peripheral retina involving rotating the eye should be avoided because incomplete attachment of the contact lens causes decreased visibility of the fundus image. The contact lens needs to be held by a skilled assis-
Wide-Angle Viewing System Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
89
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
1
Refractive powers, D
Fig. 4. Non-contact lens-type wideangle viewing system. The field of view and the focus can be adjusted by moving the front lens and the cornea or the reduction lens.
Peyman-Wessels-Landers
tant to keep the contact lens stable and perfectly upright. When using chandelier illumination, the surgeon can hold the contact lens instead of a light guide. The surgeon performs the operation with one hand, and can use the other hand to switch the chandelier light to another sclerotomy port. Another benefit of the contact lens-type wideangle viewing system is less cost compared to the non-contact lens-type wide-angle viewing system. A stereo-converter is required for the surgery, but the cost is almost reduced by half. Non-Contact Lens-Type Wide-Angle Viewing System
The benefit of non-contact lens is the ability to change the viewing angle by moving the front lens up and down and adjusting the distance between
90
RESIGHT
OFFISS
EIBOS, RUV800
the cornea and the front lens (fig. 4, table 2). When the eye is rotated to view the more peripheral areas of the retina, better visibility of the fundus can be achieved with the non-contact lenstype wide-angle viewing system than with the contact lens type. The surgical procedures are more flexible and a skilled assistant to hold the front lens is not required. This is why the noncontact lens-type wide-angle viewing system requires less training time and has a smaller learning curve. Dehydration of the corneal surface decreases the visibility of the fundus image and the corneal surface needs to be covered with viscoelastic material or a hard contact lens should be applied to avoid dehydration. The condensation on the front lens is also a factor that decreases visibility. Draping around the eye must be completely isolated from the breath of the patient to avoid condensation on the front lens.
Inoue Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
BIOM
Table 2. Catalog data of non-contact-type wide-angle viewing systems
BIOM RESIGHT OFFISS MERLIN Landers EIBOS RUV800
Diameter of front lens, mm
Refractive power of front lens, D
Viewing angle
19 17 21 14 18 20 20
132 128 120 140 132 132 132
102.9 94.9 130.2 88.9 99.9 105.8 105.8
Landers = Peyman-Wessels-Landers lens.
Ohji et al. [11] described that a meniscus contact lens combined with a non-contact lens Peyman-Wessels-Landers wide-angle system increased the intraoperative field of view and improved the sharpness of the peripheral images. Ohtsuki et al. [12] described a modified technique
to enhance the visual field through the RESIGHT wide-angle viewing system by applying a magnifying prism meniscus contact lens when the eye is rotated. This technique can eliminate the aberration so as to observe the peripheral retina when rotating the eye.
References 4 Aras C, Ucar D, Koytak A, Yetik H: Scleral buckling with a non-contact wide-angle viewing system. Ophthalmologica 2012;227:107–110. 5 Dominguez A: Oftalmoscopia cinematografica de imagen invertida. Arch Soc Espan Ophthal 1981;41:701–702. 6 Spitznas M, Reiner J: A stereoscopic diagonal inverter (SDI) for wide-angle vitreous surgery. Graefes Arch Clin Exp Ophthalmol 1987;225:9–12. 7 Spitznas M: A binocular indirect ophthalmo microscope (BIOM) for noncontact wide-angle vitreous surgery. Graefes Arch Clin Exp Ophthalmol 1987;225:13–15. 8 Shah VA, Chalam KV: Self-stabilizing wide-angle contact lens for vitreous surgery. Retina 2003;23:667–669.
9 Nakata K, Ohji M, Ikuno Y, et al: Wideangle viewing lens for vitrectomy. Am J Ophthalmol 2004;137:760–762. 10 Horiguchi M, Kojima Y, Shimada Y: New system for fiberoptic-free bimanual vitreous surgery. Arch Ophthalmol 2002;120:491–494. 11 Ohji M, Tada E, Futamura H: Combining a contact lens and wide-angle viewing system for a wider fundus view. Retina 2011;31:1958–1960. 12 Ohtsuki M, Inoue M, Uda S, et al: Combining magnifying prismatic lens with a wide-angle viewing system to enhance view of peripheral retina during vitreous surgery. Retina 2012;32:1983–1987.
Makoto Inoue Kyorin Eye Center, Kyorin University School of Medicine 6-20-2 Shinkawa Mitaka, Tokyo, 181-8611 (Japan) E-Mail [email protected]
Wide-Angle Viewing System Oh H, Oshima Y (eds): Microincision Vitrectomy Surgery. Emerging Techniques and Technology. Dev Ophthalmol. Basel, Karger, 2014, vol 54, pp 87–91 (DOI: 10.1159/000360453)
91
Downloaded by: Siriraj Medical Library, Mahidol University 198.143.39.97 - 3/26/2016 10:07:34 PM
1 Chalam KV, Shah VA: Optics of wideangle panoramic viewing system-assisted vitreous surgery. Surv Ophthalmol 2004;49:437–445. 2 Inoue M, Noda T, Mihashi T, et al: Quality of image of grating target placed in model of human eye with corneal aberrations as observed through multifocal intraocular lenses. Am J Ophthalmol 2011;151:644–652. 3 Inoue M, Noda T, Ohnuma K, et al: Quality of image of grating target placed in model eye and observed through toric intraocular lenses. Am J Ophthalmol 2013;155:243–252.
