Klaus Lucke, Silvia Bopp Bremen, Germany

While originally vitrectomy procedures took place largely in the premacular area, in recent years vitreoretinal surgeons place an increasing emphasis on thoroughly dealing with all problems in the vitreous base as well. This includes traction phenomena in anterior PVR and primary vitrectomy for retinal detachment, as well as pathological changes such as Coat´s disease and angiomatous lesions, which often localize in the extreme periphery of the retina. In macular rotation surgery the vitreous base must be cleaned thoroughly, the peripheral retina must be cut, and the reattached retina must be fixed by lasercoagulation, all in close proximity to the ora serrata.
Visualization of this space, however, remains a challenge and there are a variety of ways to go about it. We found that the BIOM II system with the super wide angle lens has helped us considerably in performing most of these tasks.
The BIOM system works without assistance and the optics can easily be moved into and out of the microscope during surgery. In pseudophakic eyes visualization past the edge of the IOL optic reaches well to the ora serrata and beyond. Disadvantages that need to be dealt with are a tendency to fogging and the short distance between lens and cornea, occasionally resulting in corneal touch and the necessity to clean the lens and reapply methyl cellulose to the cornea.
The mechanics and optics of this system are demonstrated in a series of operative video sequences.