For what indications is the bi-manual technique a particular advantage?
The technique is especially useful for treating proliferative membrane growth, macular holes, and diabetic macular edema. I have also had excellent experience using this technique for retinopathy of prematurity (ROP), where there is a proliferation of abnormal vessels in the retina. A mild version of ROP is relatively common, although the severe form is extremely rare. However, babies born before the 32nd week of pregnancy, babies with a birth weight below 1,500 grams or babies requiring artificial respiration for longer than three days are particularly at risk. Severe stages can lead to scarring, myopia or blindness due to retina detachment.
Particularly for severe cases of ROP with retina detachment, in which laser coagulation is not sufficient, the two-handed technique was helpful for dissecting the retina quickly and without any incidents. When we operate on preterm babies, we naturally try to keep the duration of the surgery as short as possible to minimize the strain on the not yet fully developed organ. This is where the benefits of the new technique for added patient safety are particularly apparent.
Do surgeons need extra training for this technique?
Any operation on the retina demands a lot of experience and a delicate touch, and the handling of the OttoFlexTM II requires particular practice. It is important to develop a feeling for the light conditions at different diameters of the auxiliary illumination to ultimately achieve an optimal image of the retina. A good exercise for confident mastery of the Leica M844 F40’s illumination technology is the use of vitrectomy lenses. This additional lens is placed on the cornea if necessary to provide a panoramic view of the ocular fundus during surgery. This exercise can be done before starting a cataract operation, for example.
Has your new technique caused a stir amongst your colleagues?
My colleagues have already heard about my new way of operating. Many ophthalmologists approach me and want to know more about it. I am naturally very pleased that other specialists have heard about my technique. I’m coming in contact with new people interested in it all the time, and we often invite ophthalmologists to watch my operations and discuss the technique with me in detail.