BASIC OF OPERATING
MICROSCOPE
Chairman- Dr. Pankaj Kumar Roy
Associate Prof. of Retina blue NIO &H
Moderator- Md. Hafizur Rahman
Consultant of Retina Blue NIO & H
Presenter: Dr. Mst.Farhana Khanam
DO, Resident NIO & H.
INTRODUCTION
Human eye extremely delicate organ
Performing ophthalmic surgery requires very nice clear
magnified viewing system
Ophthalmic operating microscope is a delicate optical
instrument.
provides surgeons a stereoscopic,
high quality magnified and illuminated image
of small structures in surgical area
History
1909, Baylor university medical center
1st ocular surgery done by Dr.Edward H . Cary
After second world war, ophthalmologist use operating
microscope at operation theater.
From 1940s to 1970s ,ophthalmologist use
Basic operating microscope for doing cataract surgery.
Optics of compound
microscope
EL
OL
Fo Fo
i
O Fe
Fe
I
Optical principles
Depth of
Magnification The field of view
field(Stereopsis)
FIELD OF VIEW
More magnification less field of view
Field of view = Fo / Ve
Here,
Fo = Focal length of Objective lens
Ve = Total Magnification of microscope
Magnification of operating microscope
depends upon:
Objective lens
Tube lens
Eyepiece lens
Total magnification =
Ft/ Fo × Ve ×Magnification factor
Here,
Ft= Focal length of tube lens
Fo = Focal length of Objective lens
Ve = Magnification due to eyepieces
Magnification factor =1.6
BASIC
DESIGN
Requirements of an operating
microscope
Stereoscopic visualization
Comparatively long working distance
Good illuminating system
Variable magnification, excellent resolution
Stable but mobile stand
An articulated & balanced suspension
Components of operating
microscope
Mechanical
Observation
Illumination support system
system(microsc (body of operating
system
ope) microscope)
Observation system
Objective lens
Binocular tubes
Eyepieces
Observation system
Objective lens
Consists of
2 plano-convex lenses
Providing a composite
power of +22 D
Commonly used
objective focal length
150, 175, 200 mm
.
Binocular tubes
Straight & inclined binocular tubes are available
Inclined tubes are mostly preferred
Binocular tubes houses :
• Inverting prism system
• Magnification changer
INVERTING PRISM SYSTEM :
Porro-Abbe prism used
to revert the inverted
image.
Porro-Abbe prism
Porro-Abbe prism
Porro
Light enters in one
flat surface.
Internally reflected
four times.
Porro Image is rotated 180
degree.
Direction of light is
same of entrance .
Magnification changer
It provide variable
magnification
Two type of
Galilean
step
magnification
changer
Zoom
Galilean step Magnification changer
It utilize Galilean telescope to alter
magnification
Step changer incorporates two telescope
Can magnify 0.4 ×, 0.63 ×, 1.0 ×, 1.6 ×, 2.5×
It consists of a rotating drum that houses
Galilean telescopes.
ZOOM MAGNIFICATION CHANGER
• Provides a continuous change of magnification
• Magnification ranging from 0.5 × to 2.5 ×
• Most advanced comfortable but
expensive.
• More Easily controlled
by foot pedal
EYEPIECE LENSES :
Constituted by an astronomical telescope system.
With adjustable eyepieces
for users with refractive
error.
It act as main magnifiers.
Magnification:10×,12.5×,
16×,20×
Provide good stereopsis
as the tubes converged
at an angle of 10°- 15°
ILLUMINATION SYSTEM
It comprises of :
Light source: halogen lamp/LED
Delivery system: Fibreoptic
Illumination arrangement:
Coaxial/Oblique or both.
ILLUMINATION SYSTEM
Why halogen/LED lamps
Cool light illuminator
High percentage of blue light
Increases the contrast of the
object
Integral light source is replaced by Fibreoptic
It reduces heat
Easier change of bulb during surgery
COAXIAL ILLUMINATION
Light is re-routed to a point very near the
viewing axis of the microscope
Projected down through the same
objective lens used for viewing
Necessary for viewing posterior capsule
& for vitreous surgery.
Coaxial illumination
OBLIQUE ILLUMINATION
provided a direct illumination system
First light deflector deflects light in the direct illumination
axis
A second light deflector redirects the light along an
oblique axis
MECHANICAL SUPPORT SYSTEM
Consists of :
Vertical stand
Rotating arm
Up and down movement
arrangement
The base wheel & locking
arrangement.
Some additional desirable features
# Variable angle assistant microscope.
# Procedure for documentation/ recording.
# Filter unit(Laser)
#Switchable beam splitter
Special optical device with operating
microscope on VR sugery-EIBOS
RESIGHT
BIOM
RECORDING
MODERN VR OPERATING MICROSCOPE
Associated with OCT
To visualized the structure of retina during operation
On table attachment of macular hole
Attachment of the ratina during RD surgery
TELESCOPE
An optical system designed to increase the angle subtended
at the eye by distant object.
Called a focal because pencils of light entering with zero
vergence, come out with zero vergence.
A TELESCOPE IS COMPOSED OF TWO PIECE OF
LENSES
1) First OBJECTIVE lens
Forms an image of distance object by bringing light to a point of
focus.
2)The second EYEPIECE or OCULAR lens
To view the image formed by the objective.
A TELESCOPE HAS TWO GENERAL
PROPERTIES
• The Aperture
A telescope collect light is directly related to the diameter of the lens.
Larger aperture, more light telescope collects & brings to focus
Brighter the final image.
A TELESCOPE HAS TWO GENERAL PROPERTIES
• Magnification:
Enlarge an image, depends on the combination of lenses
used.
Eyepiece lens performs magnification.
Any magnification can be achieved by almost any telescope
by using different eyepieces.
GALILEAN TELESCOPE
Objective plus lens & eyepiece minus lens separated by the
difference of their focal lengths.
Produces an erect magnified image
Use as a magnified aid usually mounted in a spectacle frame.
For viewing near or distant object
But difficult to combine near and distant use in the same
instrument.
ASTRONOMICAL(KEPLERIAN)
TELESCOPE
Objective and eye piece both are made up of positive lens.
Tube length is longer.
High power telescope.
4x to 15x magnification.
Field size and quality of image is better than Galilean
telescope.
Care for the operating
microscope
Keep the microscope in a dry, cool and well-ventilated
place
Every week clean the optics
Protect from dust
when not in use, drape a cover over the microscope .
Wipe down the external surfaces with a damp cloth soaked
in hot , soapy water.
If fungus growth is detected clean
Cover the foot pedal with a clear plastic bag
Use a voltage stabilizer with the microscope
Lift the foot pedal off the floor when washing the floor
Before using, test the controls of the foot pedal.
Before using ,check that the suspension arm can be fixed
into position.
Avoid kinking or bending the fibre optic cables.
When replacing the bulbs , avoid touching them with
surgeon fingers .
Do not move the microscope while the bulb is still hot
Every six months ,clean and oil the wheels and the brakes
Uses of operating microscope
Use in all types of Ophthalmic surgery
Use in endodontic
Use in ENT surgery
Use in plastic surgery
Use in neurosurgery
Conclusion
Without ophthalmic operating microscope ,we cannot think
any ophthalmic surgery
It allows a surgeon a stereoscopic ,
Magnified, high quality images
Provide surgeons better visualization & better surgical
performance
Thank you
