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176

Maximal Ingenuity for Minimal Incision. Part 2.

We continue the topic of evolution of cataract surgery and its impact on the development of capsulorhexis forceps.
In the previous post we observed the shift from 3.00 to 2.00 incision as the global tendency in cataract surgery. Now it’s time to consider tools designed for even smaller incisions.
With the evolution of intraocular lenses and possible implantation through less than 2.00 mm incision the microincisional cataract surgery gained interest.
The size of incision decreased, and it became more and more difficult to fit through it using the standard design capsulorhexis forceps. A number of internal researches indicated that the only way to guarantee the forceps won’t violate the opening of 1.50 mm is to implement a cross-action and double cross-action mechanism - this is in fact an advanced version of a traditional Inamura design.
Cross-action prevents hyperextension of the incision. Hinge joints of 3-joint forceps contribute for even better durability, providing strength to the construction due to the even distribution of stress at three points of forceps. Additional engravings on 2.50 mm and 5.00 mm indicate the desired size of capsulorhexis.
4-0395 Capsulorhexis Forceps with Scale with Cross-Action

Double cross-action is achieved by double bending of the shafts. The forceps with this mechanism have a fixed opening that contributes to free movements in the anterior chamber still not extending the edges of the wound.
4-033S Small-incision Capsulorhexis Forceps with Double Cross-Action and Scale

MICS

The latest innovation are microforceps that are able to fit through the incisions less than 1.00 mm. They minimally disrupt the biomechanics of the cornea, cause even less surgically induced astigmatism, and result in shorter recovery time with lower risk of endophthalmitis.
There is a great choice of microforceps in RUMEX range. Their delicate yet stiff 23 Ga tubes are equipped with cystotome tips to effectively perform the capsulorhexis. Engravings allow for precise measuring inside the anterior chamber.
4-03742 Lesieur Сapsulorhexis Forceps With Internal Ruler, 23 Ga
12-003T Universal Squeeze Handle
MICS tips are used with RUMEX Universal Handle and can be easily cleaned after the surgery. Proper handling promotes for longevity of the instrument. It’s incredible, but if properly cared, the instrument with internal clearance of 0.4 mm can perform more than 100 surgeries!
This chart contains the featured models of Rumex capsulorhexis forceps and will guide you to the optimal tool for the customary size of the incision:

  • regular incision - regular design enhanced with internal ruler, 4-03314T, 4-03315T or disposable 4-0331D
  • 2.0 mm - Forceps equipped with a width limiter, 4-0312S, 4-032S
  • 1.5 mm - Cross-action jaws, 4-0395, 4-033S
  • sub 1.00 mm - MICS tips, 4-03742, 4-03771



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