title: An extraocular non-invasive transscleral LED-endoilluminator for eye speculum integration.
abstract: OBJECTIVE
  Conventional chandelier-endoilluminators used for pars-plana vitrectomy consist of a light-emitting tip attached to an optical fibre. The tip requires introduction into the ocular space through an incision. To achieve complete illumination of the intraocular space, the introduction of more than just one tip is sometimes necessary. An extraocular vitreoretinal LED-endoilluminator discussed in this paper represents a new approach to illuminate the intraocular space. The light source is integrated into a speculum and firmly apposed to the sclera. This approach offers the advantage of effectively illuminating the interior of the eye even though the procedure is non-invasive. Furthermore, this approach significantly reduces the risk of damage to the retina by phototoxic effects.
  
  
  METHODS
  A round white LED was used as a light source. By integrating the light source into a speculum, the LED was firmly held against the sclera. Thus, the ocular space was illuminated transsclerally. As a result, indirect uniform illumination of the complete intraocular space was achieved. The prototype was developed considering the relevant international standards. Porcine eyes were used because their properties are similar to those of human eyes.
  
  
  RESULTS
  Porcine eyes could be acceptably illuminated with the selected LED. The LED-endoilluminator conforms with international standards for endoillumination. Thus, possible photochemical and thermal risks are considered and reduced to a minimum.
  
  
  CONCLUSIONS
  A novel LED-endoilluminator which can be attached to a speculum was developed. The system does not need any connection to an external light source and, consequently, also avoids usage of an optical fibre. Regular and uniform illumination of the intraocular space was achieved by transmitted and scattered visible irradiation, avoiding an incision. The duration of potential light exposure, compared to existing illumination systems, can be significantly increased. This is also true when the illuminator is not directly placed over the pars-plana and the distance to the retina is reduced. Only a part of the light reaches the retina and the fraction of short wavelength becomes very small. Increased safety of the system results from now being able to increase the exposure time and reduce phototoxic stress to the retina.
authors.affiliation: Department of Mechatronics and Medical Engineering, Ulm University of Applied Sciences, Albert-Einstein-Allee 55, D-89081, Ulm, Germany.
authors.forename: Philipp Simon
authors.initials: PS
authors.lastname: Kölbl
authors.forename: Christoph
authors.initials: C
authors.lastname: Lindner
authors.forename: Christian
authors.initials: C
authors.lastname: Lingenfelder
authors.forename: Svenja
authors.initials: S
authors.lastname: Deuchler
authors.forename: Pankaj
authors.initials: P
authors.lastname: Singh
authors.forename: Frank
authors.initials: F
authors.lastname: Koch
authors.forename: Martin
authors.initials: M
authors.lastname: Hessling
mesh_terms: D000818:Animals; D008027:Light; D008029:Lighting / Q000295:instrumentation*; D011833:Radiation Injuries, Experimental / Q000517:prevention & control; D012160:Retina / Q000528:radiation effects; D013525:Surgical Instruments; D013552:Swine; D057586:Vitreoretinal Surgery / Q000295:instrumentation*