Loupes for Vascular Surgery

[apocalypsem3]

Hi.

Looking for set of loupes for vascular surgery. What magnification do vascular surgeons usually use? I heard anywhere from 2.5x to 4.5x.

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[Winged Scapula]

I am sitting here in the OR lounge with two vascular surgeons and an orthopedic hand surgeon.

They all have DFV loupes. The hand surgeon uses 3.5x; the vascular surgeons use 2.5x but state they also have 3.5x which they use on occasion. Remember the latter are much heavier.

 

[ThoracicGuy]

Hi.

Looking for set of loupes for vascular surgery. What magnification do vascular surgeons usually use? I heard anywhere from 2.5x to 4.5x.

I do some vascular and I use the Design for Vision 2.5s. They are more than enough for what I've needed to do. They were also enough for doing cardiac surgeries. Remember, the higher the magnification the smaller your field of vision is.

 

[mimelim]

We bought 4 sets of loupes for our vascular residents last year, all bought 2.5x. We have one faculty that uses 3.5x and everyone else uses 2.5x.

 

[apocalypsem3]

Great. Thanks a lot for the replies.

 

[A400]

Hi.

Looking for set of loupes for vascular surgery. What magnification do vascular surgeons usually

I highly recommend Surgical Acuity Class 3 (Low or High) -- Hi Res Plus line. This is 3.3x or 3.8x if you check their website. Most people use 2.5x so that probably is enough. But I always liked having slightly more magnification, and you really don't lose too much in Field of View with the Surgical Acuity loupes. (I got the one that I use before they split it between Hi and Low levels, so I believe it was marketed as 3.5x at that time.)
But once you start going into the 4x or above, that's very specialized and you likely will go long periods without using it.
I've looked at DSV and Surgitel loupes in the past, and always felt the Surgical Acuity was better made -- it's also the most expensive of those 3 brands if that makes difference for you.

 

[droliver]

2.5x are good enough for everything short of digital/pedal vessels.

One thing I would suggest you try is to get some cheap plastic bifocal safety Googles which can be found in magnification from 1-3x. They are about $10 at Home Depot or Amazon. I haven't worn my coupes in years after discovering that. Much more convenient and I don't care if I leave them somewhere. They're essentially a disposable loupe

 

[filter07]

2.5 is enough for me, I do tibials and radials just fine with them. If you find yourself doing pedal bypasses, find a way to scrub out, so you can have enough rest for the amputation in a few hours. Don't need 3.5 to sleep.

 

[droliver]

Before you spent a bunch on formal loupes, I would try the cheap-o safety goggle thing first. I use some 1.5x as my everyday protective eye-ware in the O.R. and love it, but you can get 3x versions too. 100000% more comfortable then loupes. If you want to try that higher magnification level I'd drop $12.75 at Amazon on these Dewalt's

http://www.amazon.com/DPG59-130C-Re...r=8-3&keywords=safety+glasses+3+magnification

 

[Winged Scapula]

Before you spent a bunch on formal loupes, I would try the cheap-o safety goggle thing first. I use some 1.5x as my everyday protective eye-ware in the O.R. and love it, but you can get 3x versions too. 100000% more comfortable then loupes. If you want to try that higher magnification level I'd drop $12.75 at Amazon on these Dewalt's

http://www.amazon.com/DPG59-130C-Reinforcer-Rx-Bifocal-Performance-Protective/dp/B000646VG2/ref=sr_1_3?ie=UTF8&qid=1407899081&sr=8-3&keywords=safety glasses 3 magnification

Are you making money on this @droliver ? Two posts about it in 2 days (when we haven't seen you in months).

 

[SouthSideSteve]

I'm in CT surgery and most wear 3.5s. Some of our guys have 2.5s they wear for TAVRs or Aortic cases.

 

[Kahreek]

Before you spent a bunch on formal loupes, I would try the cheap-o safety goggle thing first. I use some 1.5x as my everyday protective eye-ware in the O.R. and love it, but you can get 3x versions too. 100000% more comfortable then loupes. If you want to try that higher magnification level I'd drop $12.75 at Amazon on these Dewalt's

http://www.amazon.com/DPG59-130C-Reinforcer-Rx-Bifocal-Performance-Protective/dp/B000646VG2/ref=sr_1_3?ie=UTF8&qid=1407899081&sr=8-3&keywords=safety glasses 3 magnification

those bifocal seems like a nice compromise, i wonder if there are 0 dioptre glass lenses like these with more stylish spectacles.

 

[Thanatos]

Hi.

Looking for set of loupes for vascular surgery. What magnification do vascular surgeons usually use? I heard anywhere from 2.5x to 4.5x.

I'm on vascular surgery right now, doing a lot of open bypass cases and their subsequent amputations lol! I wear 2.5x which is pretty much what everyone else in my program wears, including the vascular staff. I haven't had any issues seeing (I do have corrected vision with contact lenses for the record).

Just in the past week I did a common femoral to posterior tibial bypass, a handful of AV fistulas, and a below knee pop to a pathetically calcified 2mm dorsalis pedis artery. Seeing the DP was not the issue, finding a space to put the needle in all the plaque was the hard part.....I'll be teeing that bka up sometime in the next week I'm sure.

I wear surgical acuity with oakley frames, they are a lighter than the DFV loupes and I like that they protect my eyes. It's not uncommon to get sprayed when "testing" the inflow or when the attending sprays heparinized saline everywhere and the buddy holly/henry kissinger DVF glasses don't really protect your eyes unless you want to wear a mask with a shield or the plastic lateral extension things that make you look like your high school wood shop instructor.

Our cardiac staff wear 3.5x for CABG but it seems like everyone else does 2.5x.

 

[thedrjojo]

our program buys us loupes and pays for the 2.5x magnification, so pretty much all of us get the 2.5x. We can pay extra if we want the 3.5x, but i dunno if anyone does.

 

[knickleforth]

I'm currently looking into buying a pair of loupes myself. Since I'm going into hand surgery I am looking to buy a pair of 3.5x loupes. At these magnifications optical quality is supposed to be better with prismatic loupes.
Because I prefer TTL systems the only two options i have at the moment are:
- DFV 3.5 EF
- Exam-Vision Kepler 3.5

Exam-Vision seems to be fairly new, and I cannot really find additional information on it. Is anyone using a pair of them?

 

[apocalypsem3]

Don't forget Surgitel, Orascoptic, Q-optics, Univet to name a few others offering 3.5x loupes.

 

[Admire]

you ought to try prismatics from univet they are awesome

 

[MWaseem]

Hi.

Looking for set of loupes for vascular surgery. What magnification do vascular surgeons usually use? I heard anywhere from 2.5x to 4.5x.

hi i am looking for vascular surgery residency list, i have J-1 VISA, PLEASE

 

[Winged Scapula]

hi i am looking for vascular surgery residency list, i have J-1 VISA, PLEASE

Vascular Surgery residencies are very competitive and as a foreign grad on a visa, you are unlikely to match.

In addition, this thread is about surgical loupes not looking for positions in Vasc Surg. There is a forum for Positions Wanted/Open Positions. You may post your need there.

 

[MWaseem]

Vascular Surgery residencies are very competitive and as a foreign grad on a visa, you are unlikely to match.

In addition, this thread is about surgical loupes not looking for positions in Vasc Surg. There is a forum for Positions Wanted/Open Positions. You may post your need there.

THANX

 

[MWaseem]

THANX

CAN U PLZ SEND ME LINK

 

[Winged Scapula]

CAN U PLZ SEND ME LINK

http://forums.studentdoctor.net/forums/internship-residency-and-fellowship-positions.290/

or

http://lmgtfy.com/?q=open+residency+position+sdn

 

[MWaseem]

http://forums.studentdoctor.net/forums/internship-residency-and-fellowship-positions.290/

or

http://lmgtfy.com/?q=open residency position sdn

thanx

 

[Kaustikos]

http://forums.studentdoctor.net/forums/internship-residency-and-fellowship-positions.290/

or

http://lmgtfy.com/?q=open+residency+position+sdn

You're too awesome

 

[bottombracket]

Buy a pair of Surgical Acuity 3.8x (their class III high) loupes. I'll tell you why:

(disclaimer: I'm a plastic/hand/microsurgeon. I can hear your replies now: "I can see everything I need to see already." "Everyone else wears 2.5's". "You're not even a general surgeon, you hand weenie." etc... Bear with me.)

1. Cost to value ratio. At 2.5x you are wasting $1200. You can buy an optically darn good pair of safety glasses as droliver said or even a pair of 1.5x readers at Walmart that will do 3/4 of what a 2.5x loupe will do. The magnification that you get for a 2.5x loupe is not worth the money. My first pair of loupes as a PGY-2 were DFV Buddy Holly 2.5's, 'cause that's what all my general surgery friends had. They were fine for vascular but inadequate for plastics so I upgraded to Surgical Acuity 4.3's (class IV low in their terminology) and then I realized that...

2. Detail. You can't tell what you are missing at 2.5x. The level of detail that you see at 3.8x (yes, or 4.3 in my case) is a world of difference. Before you go with 2.5s, borrow a pair drilled to your size (demo pair that fits from a rep, friend, coresident), or find a pair of adjustables (Zeiss, Surgitel, etc) and actually try operating for a week with a 3.5 or 3.8 loupe. Please do this. Trust me. Better yet, try it yourself.

3. Field of view. The field of view is not too small. This was my initial concern on wearing a higher power loupe for daily use. I have worn my 4.3's exclusively for the past 5 years; initially, I thought I'd switch back and forth, use the 2.5's for daily work and 4.3's for hand, kids, micro. Nope. For me at least, once I got used to seeing more and better with bigger loupes, I wanted to keep seeing fine detail. The DFV 3.5's and SA 3.8's both have a perfectly fine field of view for everyday work.

3. Weight. 3.5x expanded field DFVs are heavy and can be hard on your nose. They are still great loupes if you can handle the weight. And for the love of goodness, never EVER buy a non-expanded field DFV 3.5 x loupe. They have a very small field of view and light transmission is terrible. My wife (also plastics) made this mistake and returned them immediately.

4. Surgical Acuity's are nice because the frames are titanium (lightweight), but most importantly, each eyepiece's objective can adjust in and out to account for prescription changes/inaccuracy in fitting. Additionally, the field of view is large. Be careful with their titanium 'sport' frame - it's whippy and flexible, and requires precise placement on your head. The original frame with round lenses is much stiffer.

To summarize: Buy at least a 3.5x loupe; the benefit of added optical clarity is huge and it won't compromise your operative field of view. Surgical Acuity makes good loupes that are light and adjustable.

All right, hit me with the flames. But please, give a pair of higher powered loupes a shot before settling on 2.5x's of any kind. It will make a positive difference no matter what your chosen surgical discipline.

bb

 

[knickleforth]

I live in Europe and most of my colleagues have Zeiss 3.5 prismatic loupes. Not only are they heavy, but the loupes are mounted in front of the glasses. That means they constantly move and have to be readjusted. But probably even more important, the loupes are simply further away from the eyes, so the image you get is smaller.

The rep for Exam-Vision (Europe's answer to DFV and Surgial Acuity) has left me a pair of fitting Kepler 3.5 loupes. They are amazing! I have tried these loupes for a few days now and have compared them with the Zeiss. The optical quality is identical with a clear image to the edges, wide field of view and a good depth of field. These loupes are incredibly light weight. The loupes are individually adjustable and can be upgraded to higher magnification, should the need arise. But they are expensive!

Getting a DFV or Surgical Acuity is not really an option here. Most surgeons here who have DFVs or Surgical Acuity got them at a conference in the US (where they are considerably cheaper). The reps don't have any fitting pairs and if I were to have a problem with the loupes sending them for repair would be quite the hassle. One of my attendings had a crack and needed to get it fixed. Because it took so long, he actually got a cheap 2.5x loupes just to bridge the weeks it took the loupes to get back.

That said, I'm buying a pair of Exam-Vision.

@bottombracket Thanks for your advice. Possibly one of the best comments I've read so far on the topic!

 

[apocalypsem3]

Just re-iterating what above two posts.... I went with Exam-Vision Kepler 3.5x loupes.

My colleague bought a DFV 2.5x loupes. Upon trying them on (it wasn't fitted to me), I realized the magnification was just not great enough to justify the cost. Tried Surgitel and DFV 3.5x, but the frames they have available for my facial features and needed Rx was just not comfortable for me.

Did some internet search and found Exam-Vision. The frames fit great to me and looks great as well. It's a little bit more expensive than Surgitel, DFV, and Orascoptic, but I think overall build quality is much better in my opinion. Images are crystal clear like most high-end loupes. Field of view and depth of field is large enough for my use for standing and sitting procedures in the OR. The additional feature of adjusting working distance (like Orascoptic) is great as I can fine-tune the focus. They weigh in at 75g which is much lighter than other brands. Honestly, I don't notice the weight too much as I am eye glass wearer my whole life.

For now, I am very happy with 3.5x magnification for vascular work. May be I will try 4.5x loupes in the future and upgrade if I the level of detail that can be seen is drastically better.

 

[TupacalipseT96]

Before you spent a bunch on formal loupes, I would try the cheap-o safety goggle thing first. I use some 1.5x as my everyday protective eye-ware in the O.R. and love it, but you can get 3x versions too. 100000% more comfortable then loupes. If you want to try that higher magnification level I'd drop $12.75 at Amazon on these Dewalt's

http://www.amazon.com/DPG59-130C-Reinforcer-Rx-Bifocal-Performance-Protective/dp/B000646VG2/ref=sr_1_3?ie=UTF8&qid=1407899081&sr=8-3&keywords=safety glasses 3 magnification

Just wanted to note that I excitedly ordered these yesterday after reading this thread. They arrived today and I quickly realized that they probably won't work for most people, including myself. It's not 3x as implied above, it's +3.0 diopter adjustment. So if you are an attending with presbyopia these might work for you, but for us young residents who are still nearsighted or with normal vision, these don't magnify anything they just move the focal distance to 3 inches in front of your face. They are essentially just reading bifocals my grandpa used to use.

I did some reading about the relationship between diopter and magnification which leads me to believe that unless you are far-sighted, I'm not sure a simple solution like this exists. I have to hold these glasses an arms length away from my face for them to magnify anything and be in focus.

I met with the Orascopic rep yesterday and really thought I had beat the system when I saw this post, but alas unless someone else knows a pair of these goggles that works for the rest of us I may have to drop the $1500 after all.

 

[ACSurgeon]

Just wanted to note that I excitedly ordered these yesterday after reading this thread. They arrived today and I quickly realized that they probably won't work for most people, including myself. It's not 3x as implied above, it's +3.0 diopter adjustment. So if you are an attending with presbyopia these might work for you, but for us young residents who are still nearsighted or with normal vision, these don't magnify anything they just move the focal distance to 3 inches in front of your face. They are essentially just reading bifocals my grandpa used to use.

I did some reading about the relationship between diopter and magnification which leads me to believe that unless you are far-sighted, I'm not sure a simple solution like this exists. I have to hold these glasses an arms length away from my face for them to magnify anything and be in focus.

I met with the Orascopic rep yesterday and really thought I had beat the system when I saw this post, but alas unless someone else knows a pair of these goggles that works for the rest of us I may have to drop the $1500 after all.

Does your program not buy loupes for you?