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Operating in the Dark A Night-Vision System for Surgery in Retinas Susceptible to Light Damage

András M. Komáromy, DrMedVet, PhD; Gregory M. Acland, BVSc; Gustavo D. Aguirre, VMD, PhD
Arch Ophthalmol. 2008;126(5):714-717. doi:10.1001/archopht.126.5.714.
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A standard operating microscope was modified with a bandpass infrared filter in the light path and infrared image intensifiers for each of the 2 eyepieces. We evaluated this system for subretinal injections in normal control dogs and those with a mutation in the rhodopsin gene. Rhodopsin-mutant dogs are a model for human autosomal dominant retinitis pigmentosa, and their retinas degenerate faster when exposed to modest light levels as used in routine clinical examinations. We showed that the mutant retinas developed severe generalized degeneration when exposed to the standard operating microscope light but not the infrared light. The modified operating microscope provided an excellent view of the ocular fundus under infrared illumination and allowed us to perform subretinal injections in the retinas of the rhodopsin-mutant dogs without any subsequent light-induced retinal degeneration.

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Figure 1.

The Zeiss OPMI 6 operating microscope (Carl Zeiss Inc, Oberkochen, Germany) modified with the monocular night-vision system (Owl Nitemare Third Generation; BE Meyers & Co, Inc, Redmond, Washington). The arrow points to the location of the slider housing the infrared bandpass filter.

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Figure 2.

Photomicrographs show retinas of rhodopsin-mutant dogs 15 days after subretinal injection of isotonic sodium chloride solution. With the use of the standard operating microscope light, the retinas showed extensive outer retinal and retina pigment epithelial degeneration in the injected (A and B) and noninjected (C and D) areas of different dogs. With the use of the night-vision system and infrared light in the fellow eyes, the retinal morphologic features remained normal in the injected areas (E and F) (hematoxylin-eosin; calibration marker, 50 μm).

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Figure 3.

Comparison of brightness settings between the OPMI6 and VISU160 operating microscopes (Carl Zeiss Inc, Oberkochen, Germany). The gray area shows the range of commonly used VISU160 settings (0.3-0.6) that were overlapped with the OPMI6 settings evaluated in this study (3.5-5.0).

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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