Approximately 59 ASORN members familiar with vitrectomy cases provided insight and some comments to the following questions. Results in parentheses are given as individual responses, not percentage.
- During vitrectomy surgery a special wide-angle lens may be used to view the retina. The lens, e.g. AVI or Machemer, is inserted into a handle and held by an assistant. In your practice is this lens held by:
- The scrub nurse or tech (only one scrub on the case who does everything) (37)
- A second nurse or tech who may also cut sutures and irrigate the eye (8)
- A resident or fellow assisting with the case (14)
- I do not work on vitrectomy cases (80)
- In my practice, certain physicians use a system that does not require someone to hold, such as:
- A ring sutured in place (Tanno lens) (17)
- An attachment to the microscope (BIOM lens) (42)
- I am not familiar with these systems (74)
- Comments:
- We use first the BIOM, and have available the Volk lens, sew on lens set, and irrigating lens.
- Most of the time we use disposable contact lenses especially on 25 g. cases.
- 75-80% of the cases we use the BIOM; 15-25% of the cases we use the hand held Machemer with the resident, Retina Surgical Assistant, or scrub nurse holding the lens.
- We have always had 2 scrubs on retina cases to assist. One holds the lens and the other passes instruments, etc.
- We use the BIOM in addition to the Machamer on some cases.
- Our practice generally uses the Tanno lens unless a wider angle view is required; then we switch to the BIOM lens.
- There is also a new Volk lens in Canada which just sits on the cornea and is not sutured in, thus decreasing surgical times and is easily handled by the surgeon and scrub nurse. This is a product of Innova.
- There is a sew-on lens specific for the AVI lens. It works very well.