A Guide to Surgical Loupes for Ophthalmology

A Guide to Surgical Loupes for Ophthalmology

Surgical loupes are essential for some cases because they enhance and magnify the field for accuracy and precision during the surgery. These telescopes are uniformly used in oculoplastic procedures, most strabismus cases and some retinal cases, among other specialty cases. They can be helpful for everything from very large tumor resections down to a simple suture removal in the clinic.

When choosing loupes, it is important to consider the work you are doing. For most ophthalmologic cases, a 2.5x magnification is sufficient. Higher magnification is useful for surgeries involving vascular ligature, but in ophthalmology, most work requiring higher magnifications can be done with an operating microscope.

Whether you choose ‘through the lens’ or ‘flip up’ loupes is up to personal preference. The advantage of through the lens is that you never have to adjust the loupes. They are fit specifically for you and your pupillary distance. Flip up lenses can be adjusted for different users if you decide to share. Working distance and angle of the loupes can matter for your posture. Many companies have focused on creating a loupe that will decrease the stress on the surgeon’s neck, an important aspect when considering our field.

Finally, frame styles differ. There are traditional thick black frames and newer sporty styles. Wrap-arounds will provide more protection from bodily fluids and flying objects, yet sport frames can be more stylish. The black aluminum frames distribute weight. These are some of the considerations when choosing loupes but all should be taken into consideration.

Below is a discussion of various loupes and their specifications.

Designs For Vision - www.designsforvision.com

Designs for Vision makes some of the most popular surgical and dental loupes. These loupes come with precision-coated optics allowing for easy viewing transition between the magnified and unmagnified fields. This precision multilayer coating reduces reflection to yield 99.5% light transmission.

Personal prescriptions, interpupillary distance, angle of declination and working distance can be put into these lenses. They come in a wide variety of magnifications. The Standard Field Surgical Telescopes come in 2.5x, 3.5x, and 4.5x magnification. They also carry a line of Expanded Field Telescopes that come in 3.5x-EF, 4.5x-EF and 6.0x-EF magnifications. These Expanded Field Telescopes provide a 50% increase in the field of view over the Standard Field Telescopes. These loupes are designed and manufactured ‘Thru-the-Lens” to increase field size, decrease vertex, reduce weight and eliminate hardware that can cause the telescopes to come out of alignment.

This company makes a variety of frame designs. The standard is the Yeoman, an aluminum frame that distributes the weight of the telescopes evenly. These have an anodized black matte finish that does not reflect light and they come in 112 sizes.

The ‘New Yeoman’ is the same frame offered in different colors: gloss red, blue, pink, and white. They also offer the sporty look in the frame designs seen below, all of which are very similar and differ in slight details. The Nike Skylon Ace, below, comes in black, red, navy and white.

The SkyView is similar and comes in brown, black, silver and purple. The Nike Pounce comes in walnut, silver and black. The Nike Revolve comes in silver, walnut and black. The Nike Curfew comes in black, walnut and silver.

The designer frames can also be ordered in a variety of colors. The Designer 109 comes in chocolate brown titanium, rose, gold, blue and silver. The Designer 047 comes in gold and tortoise. Finally, they offer the Titanium 062, available in chocolate brown.

SurgiTel - www.surgitel.com

SurgiTel offers loupes with a patented posture enhancing technology, weight distributing frames and a partnership with Oakley to provide sturdy and stylish frames. These loupes come in a variety of styles. Micro Line is offered in 2.5x to 4.5x and micro prism 3.0x. Compact Line is also offered in 2.5x to 4.5x. PrismPro Line is offered in 5.5x to 8.0x. All of the telescopes can be placed through the lens or mounted to the frame.

In addition to traditional loupes, SurgiTel offers loupes with x-ray protection lenses, laser filters, prescription or regular lens options, image enhancement filters and polarizing filters for glare reduction and enhanced clarity.

SurgiTel also offers resident programs and special student pricing with free trials. They also recommend and offer loupe refurbishment every year.

Sheer Vision - www.sheervision.com

This company partners with Under Armour Performance Eyewear and offers a large variety of loupe models with lifetime warranty on their products. The loupes can be flip up and adjustable or through the lens.

Both have a steep ergonomic angle to minimize neck discomfort and are available in 2.5x, 3.0x, 3.5x and Edge High Mag, an innovative design that combines prism and Galilean designs. Frame choices include Under Armour, Titanium, and Del Rey frames.

The company also offers ‘Valu-Max’ loupes, which are used and discounted by 50%.

Zeiss - www.meditec.zeiss.com

Zeiss makes mounted loupes in two forms.

EyeMag Smart - These loupes are with 2.5x magnification and are available in sports or titanium frames.

EyeMag Pro F and S - These loupes are available in a magnification range of 3.2x to 5x. For the EyeMag Pro S there is a fiberoptic cold light source available.

Keeler - www.keelerusa.com

These loupes come in spectacle or headband mounted designs and have a choice of 4 working distances (34cm, 42cm, 46cm, and 50cm). The options for magnification are 2.5x, 3.0x (with 15% increased field of view) 3.5x, 4.5x, and 5.5x. The SuperVu XL loupes (3.5, 4.5 and 5.5x magnification) come with a soft carrying case, an autoclavable flip lever and cleaning cloth.

Luxtec - www.integralife.com

Luxtec makes detachable, adjustable loupes so that more than one set of loupes can be ordered to fit the same frames. There is a choice of four different working distances. These loupes come with an aluminum PD bar to adjust to an individual’s PD, an autoclavable flip lever and caps. Galilean loupes are offered in 2.5x or 3.0x magnification. Prismatic loupes are offered in 3.5x, 4.5x or 5.5x magnification.

The sport frames offered with these loupes have wrap-around side arms with an adjustable nose pad. These frames are available in four different colors and can be worn over glasses or with prescription put into them.

This article discusses some of the many loupes offered by different companies. When choosing the right loupes, consider the optimal magnification for the type of work you are doing, whether you prefer adjustable or through the lens design, and weight of the unit. In my personal experience, I own both adjustable, mounted Zeiss 3.3x magnification loupes and Designs for Vision ‘Thru-the-Lens’ 2.5x magnification loupes. The view of the Zeiss loupes is great, but adjusting them so I have the perfect field of view can be challenging and time consuming each time I take them out of the box. My Designs for Vision ‘Thru-the-Lens’ loupes are fantastic. They provide sufficient magnification for all of the surgeries that I perform and always provide a great field of view.

Bottom line: Choose loupes that are comfortable and suitable to your everyday needs.

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