ZEISS Microscopes for Microsurgery

This book has been conceived as a reference for all those who want to deepen their knowledge of technical details, design concept and interac­ tion of the individual modules of Zeiss operation microscopes. The sub­ jects of the book are classified in accordance with our intention. Special emphasis has been placed on practical hints for the user of opera­ tion microscopes to avoid operating errors. Parameters which are of para­ mount importance for surgeon and assistant such as PD and diopter set­ ting are therefore described in detail. The effects of wrong adjustments are indicated. The above statements also apply to the ample selection of acces­ sories for Zeiss operation microscopes. That is why much attention has been given to the accessories for co-observation and documentation. The most frequently used formulae are liste~ in the last chapter of the book, supplemented by nomograms which allow the reader to determine the most important data of a specific piece of microscope equipment without calculation. Our thanks are due to all those who assisted in preparing the manuscript, drawings and photographs, to Mrs. Ursula Gabler for making the English translation and Miss Helen Robertson for editing it, and last but not least to the Springer-Verlag for the most careful, qualified and excellent pro­ duction of the book.

1 The technical principle of operation microscopes.- 1.1 Minimum demands on magnifying systems: prism loupes.- 1.2 Additional demands on magnifying systems: operation microscopes.- 1.3 Diagrams illustrating the design principle of Zeiss operation microscopes.- 2 The modules of an operation microscope.- 2.1 Objectives.- 2.1.1 Focal length.- 2.1.2 Working distance.- 2.1.3 Image quality.- a) Distortion.- b) Chromatic aberration.- c) Spherical aberration.- d) Field curvature.- e) Astigmatism.- 2.1.4 Anti-reflection coating.- 2.1.5 Image brightness.- 2.2 Binocular tubes.- 2.2.1 Straight tubes, inclined tubes.- 2.2.2 Focal lengths of binocular tubes.- a) Different overall lengths.- b) Different magnifications.- c) Different field-of-view diameters.- d) Image brightness.- 2.2.3 Interpupillary distance (PD).- a) PD adjustment.- b) PD adjuster.- 2.2.4 Tiltable binocular tube.- 2.3 Eyepieces.- 2.3.1 General functions.- 2.3.2 Individual functions.- a) Microscope magnification and field-of-view diameter.- b) Diopter setting.- c) Correct use of the eyepieces.- d) Frequent mistakes in the use of operation microscopes.- 2.3.3 Micrometer eyepieces.- a) Micrometer disks for measurement.- b) Micrometer disks as focusing aids.- 2.4 Magnification changers.- 2.4.1 Galilean step magnification changer.- a) 5-stage magnification changer.- b) 3-stage magnification changer.- 2.4.2 Zoom magnification changers.- a) Zoom system 1:5.- b) Zoom system 1:4.- 2.4.3 Parameters relating to a microscope with magnification changer.- a) Total magnification of a complete operation microscope.- b) Field-of-view diameter of the complete operation microscope.- c) Depth of focus of the complete operation microscope.- 3 Illumination systems for operation microscopes.- 3.1 Light sources.- 3.1.1 Incandescent lamps.- a) 6 V 30 W incandescent lamp.- b) 6 V 50 W incandescent lamp.- c) 6 V 25 W incandescent lamp.- 3.1.2 Halogen lamps.- a) V 100 W halogen lamp.- b) Power supply of the 12 V 100 W halogen lamp.- 3.2 Light-transfer systems.- 3.2.1 Integral illumination systems.- a) Illumination beam paths of Opmi 1, 6, and 9.- b) Illumination beam paths of Opmi 1 H and 6 H.- c) Special illuminators for ophthalmic microsurgery.- 3.2.2 Fiber optics systems.- 3.3 Types of illumination.- 3.3.1 Coaxial illumination.- a) Principle.- b) Angle separating illumination and observation.- c) Narrow body cavities.- d) Object-side limitation of observation beam paths.- e) Operation microscopes with coaxial illumination.- 3.3.2 Oblique illumination on the microscope.- a) Fiber optics illumination.- b) Focusable illuminator.- c) Electronic flash unit.- 3.3.3 Separate oblique illuminator.- a) Homogeneous illuminator.- b) Slit illuminator.- c) 30° motorized slit lamp.- d) Twin lamp.- e) Operating lamps.- 3.4 Filters in the illumination beam path.- 3.4.1 Heat filters.- a) Reflection-type heat filters.- b) Absorption-type heat filters.- 3.4.2 Color filters.- a) Green filters.- b) Blue filters.- c) Insertion of filters in the beam path.- 3.5 Comparison of different illumination systems.- 4 Couplings.- 4.1 Basic equipment for different microsurgical disciplines.- 4.1.1 Hand surgery.- a) Opmi 2 operation microscope.- b) Opmi 7 D operation microscope.- 4.1.2 Neurosurgery.- a) Standard coupling.- b) Inclined coupling.- c) Mobile coupling.- 4.1.3 Ophthalmic microsurgery.- 4.1.3.1 Equipment for microsurgery of the anterior segments of the eye.- a) Straight coupling.- b) Tilt coupling.- c) x-y coupling.- 4.1.3.2 Equipment for microsurgery of the anterior and posterior segments of the eye.- 4.1.4 Otorhinolaryngology.- a) Operation microscopes Opmi 1, 6, and 6S.- b) Operation microscopes Opmi 1 H and 6 H.- c) Operation microscopes Opmi 9 and 9 F.- 4.1.5 Vascular and plastic surgery, and surgery of peripheral nerves.- a) Operation microscopes Opmi 1, 1 F, and 1 H.- b) Operation microscopes Opmi 6, 6 S, 6 F, and 6 H.- c) Operation microscopes Opmi 7 D and 8 D.- 4.2 Frequently used couplings.- 5 Stands.- 5.1 Floor stands.- 5.1.1 88 m stands.- a) Standard I.- b) Standard II.- c) Universal.- 5.1.2 1 m stand for colposcopes.- 5.1.3 Motor stands.- a) Motor stand without continuous mechanical heigh adjustment..- b) Motor stand with mechanical height adjustment.- 5.1.4 Mobile floor stand for neurosurgery.- 5.1.5 Ear, nose, throat (ENT) stand.- 5.2 Ceiling mounts.- 5.2.1 Electro-hydraulic and electro-mechanical ceiling mounts.- 5.2.2 Mobile ceiling mount for neurosurgery.- 5.2.3 Mobile ENT ceiling mount.- 5.3 Diagnosis microscope on wall mount.- 5.4 Diagnosis microscope for ENT diagnostic unit.- 5.5 Colposcope swivel arm.- 5.6 Table stand.- 6 Supplements and accessories.- 6.1. Beamsplitters.- 6.1.1 Beamsplitter.- 6.1.2 Stereo beam splitter.- 6.2 Assistant’s microscope.- 6.2.1 Assistant’s microscope on double microscopes.- 6.2.2 Assistant’s microscope on the main microscope.- a) Assistant’s microscope 27°.- b) Assistant’s microscope 16°.- c) Assistant’s microscope 8°.- 6.3 Co-observation equipment.- 6.3.1 Monocular co-observation systems.- a) Short co-observation tube.- b) Long co-observation tube.- 6.3.2 Stereo co-observation tube.- 7 Asepsis and methods of sterilization.- 7.1 Sterility of operation microscopes.- 7.1.1 Instrument and accessories draped in sterile cloths for asepsis.- 7.1.2 Complete sterilization of the operation microscope.- 7.1.3 Microscope partially draped for asepsis.- 7.1.4 Electrical controls.- 7.2 Sterilizable sleeves and caps.- 7.3 Methods of sterilization.- 8 Documentation equipment.- 8.1 Still photography.- 8.1.1 Illumination equipment.- 8.1.2 Photo adapters.- a) Photo adapter.- b) Automatic photo adapter.- c) Twin adapter.- 8.1.3 35 mm camera.- 8.1.4 Photography.- a) Equipment of the operation microscope.- b) Settings of the photographic system.- c) Settings of the microscope.- 8.1.5 Film material.- 8.1.6 Frequently used formulae.- a) Magnification referred to the film plane.- b) Dimensions of the object field.- 8.2 Cine photography.- 8.2.1 Illumination systems.- 8.2.2 Cine adapter and cine cameras.- 8.2.3 Film material.- 8.2.4 Practical cine photography.- a) Equipment of the operation microscope.- b) Settings on the cine equipment.- c) Settings on the microscope.- 9 Maintenance of the operation microscope.- 10 Formulae.- 10.1 Optical properties of operation microscopes.- 10.1.1 Magnification.- 10.1.2 Object fields.- 10.1.3 Numerical aperture.- 10.1.4 Graphic representation of the most important data (nomogram N 1)..- 10.2 Detector properties.- 10.2.1 Observation.- 10.2.2 Documentation.- 10.3 Terms of the diffraction theory.- 10.3.1 Airy disk.- 10.3.2 Limit of resolution.- 10.3.3 Axial extension of the diffraction pattern.- 10.4 Useful magnification.- 10.5 Useful f/number.- 10.6 Depth of focus.- 10.6.1 Visual observation.- 10.6.2 Documentation.- 10.7 Illumination intensity in the film plane.- 10.7.1 Coaxial illumination.- 10.7.2 Oblique illumination.- 10.8 Stereopsis.- Literature.