Surgical Loupes recommendations? DFV/Oracoscoptic/ExamVision/Zeiss/Surgitel/others?

[Medstart108]

I'm a cardiothoracic resident looking into a new pair of loupes. I currently have DFV 2.5s TTL EFs but I want to upgrade the zoom so that I can do distals coronaries. While i've been relatively happy with the customer service, I've found that DFV loupes are fickle, the optimal clarity of vision only happens when loupe is positioned in a certain way on my face and I was surprised when I tried surgitel how large and clear the field of view is. I haven't had the chance to meet with the reps from other manufacturers yet.

However, i'm still debating whether or not I want to use 3.5s or 4.5s and for that reason I've also considered adjustable loupes like the Eyezoom Oracoscoptic or Examvision Kepler Advanced. Does anyone have any experience with those? If I do choose DFV, does anyone know the differences between the Panoramic vs Expanded Field scopes?

I'm also in the market for a LED headlight, does anyone have recommendations for a light manufacturer? Ideally something that has a wide light and is long lasting.

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[deleted50541]

I have the DFV microEF 3.5s and have been pretty happy with them. Wore them all through fellowship and use them when I'm doing open thoracic cases now. The DFV panoramics are new and I'd be curious to know how much weight they add to the frame and the perceived benefit of an additional 3.5 cm diameter field. Also what the extra cost is.

Go with what works for you. I know folks who swear by their Surgitel loupes and it seems like you thought the optics were better.

 

[LucidSplash]

I love my Surgitel 3.5x. I’m Vascular and do a fair amount of distal tibial and pedal bypasses. The attachable headlight is great for these cases as well. I actually prefer to still use my 2.5x surgitels from residency for aortic cases, as I find the extra distance for the RP approach I use lends itself to some issues with focal length when using the 3.5x. Also the headlight is not strong enough for the RP cases in my opinion.
I have never used anything other than surgitel, so I can’t compare to anything else.

I will say that DFV maybe has a bit better customer service that Surgitel. My loupes broke in fellowship and I had to send them in for repair and it took almost 2.5 months to get them back and it wasn’t inexpensive even though the loupes were only 18 months old. One of my cofellows sent his DFV in and it only took a couple weeks and it was pretty cheap. That is entirely anecdotal experience however.

 

[bottombracket]

Lord, here I go again...I only visit here about once a year and I swear I only seem to comment on loupes threads.

I rocked Surgical Acuity (now Orascoptic) 4.3x loupes (plastics/hand/microsurgery) for the past decade or so. Last month my loupes were stolen. I wanted to replace them with the same pair, but Orascoptic has moved on to a new design. I upgraded to their new 4.5's and HOLY CR@P are they good. They are so bright, and the optical clarity is just outstanding. I was literally shocked at how much better these are than my old loupes. I would urge you to try a pair on, even if you look at the 3.5's.

I have worn 4.x loupes daily for everything, including flap dissection, micro, skin closure...everything. It is not too much magnification. The field of view is not too small. I have their ti frames and they are stiff and easy to locate the loupes on your face to keep things in focus (the 4.3 SA's I had were very, very touchy and you had to align them perfectly to keep things in focus).

I dig these things like a ditch. Take a good look at Orascoptic before buying others.

 

[310prolene]

Lord, here I go again...I only visit here about once a year and I swear I only seem to comment on loupes threads.

I rocked Surgical Acuity (now Orascoptic) 4.3x loupes (plastics/hand/microsurgery) for the past decade or so. Last month my loupes were stolen. I wanted to replace them with the same pair, but Orascoptic has moved on to a new design. I upgraded to their new 4.5's and HOLY CR@P are they good. They are so bright, and the optical clarity is just outstanding. I was literally shocked at how much better these are than my old loupes. I would urge you to try a pair on, even if you look at the 3.5's.

I have worn 4.x loupes daily for everything, including flap dissection, micro, skin closure...everything. It is not too much magnification. The field of view is not too small. I have their ti frames and they are stiff and easy to locate the loupes on your face to keep things in focus (the 4.3 SA's I had were very, very touchy and you had to align them perfectly to keep things in focus).

I dig these things like a ditch. Take a good look at Orascoptic before buying others.

I second the vote for orascoptic. I have 3.5s and 2.5s. Use them daily for hand, microsurgery, and aesthetic surgery. Love them. Light weight, wide field, good depth. The few times I’ve had to deal with customer service, it has been easy.

 

[Jolie South]

I have found the opposite to be true between Surgitel and Designs for vision. I love my DFV. I have had great customer service. I love the clarity of the loupes.

I also have a pair of Surgitel loupes. Same prescription. Both 2.5s. The loupes are aligned correctly but there some kind of weird curvature to them that gives me vertigo if I look around to quickly. I also find them less comfortable and the actual clarity way inferior to DVF. I have them in my car in case I forget my good loupes at one hospital. But honestly, I would almost rather not wear loupes than wear those.

 

[TypeADissection]

I have only used DFV and have both the 2.5x and 3.5x. Using the 2.5x probably 90% of the time and only bust out the 3.5x when doing distal tibial work and the handful of pediatric bypasses I've done for traumas and whatnot. The 2.5x as you already know are great workhorses that'll allow you to do almost everything. The 3.5x I have found to be fickle on my face mostly bc I don't have a great nose bridge for them. So I had to make some adjustments and add some padding otherwise I can't see through the loupes to do what I need to do. Haven't tried anything else and was looking into trying the Univets but then COVID happened and I forgot about them.

 

[BovieToMe]

I have both DFV 2.5x and 3.5x EF. I have not tried any other loupe manufacturer. I wear the 3.5x EF most of the time because I extended the working distance on them. The field of view is almost the same between the 2.5x and 3.5x EF.

I like the 3.5x EF for a few reasons but there are some drawbacks. The zoom is better, but the eyepieces are wide and thus basically fill your entire line of sight. Meaning it is difficult to ever use the non-telescope portion of the lens. The loupes obstruct your view much more than the 2.5x. Additionally, the telescopes do not let as much light through. I often cannot do cases without a headlight with the 3.5x that I could do with the 2.5x.

I think for cardiac surgery, 2.5x are fine for most people. I do find that the distals look huge with the 3.5x, but I have personally never found the "seeing" part to be the difficult part. It's usually more the sewing part.

Lastly, the loupes are heavy and do not stay on your face. Mine do not rest on my nose, they basically stay in place because they're strapped tightly to my face.

 

[Mr Cookie Pants]

Hi, sporadic logger onner here. Finishing CT Fellowship this week.

I have DFV 2.5 EF on a Nike Frame - super comfortable, can wear for 30 hours straight without neck and eye fatigue. I wore them in GS for all Vascular and H&N cases, now I wear them for valves, aorta and open thoracic. Theyre so comfortable, sometimes I just wear them as eye protection.

I have DFV 3.5 EF on Yeoman (buddy holly). Very classic. I dont like them much as I find them to be heavy and uncomfortable on the nasal bridge. I wear them for coronaries and congenital. They're great.

An attending got Surgitels 3.5 and they're unreal. I will be getting those as an attending. Hes 6'4 and stands up taller than I do at 5'10. lighter, wider field and more comfortable.

Long story short, you need 3.5s for CT surgery. For vision - as youre learning distals and your sub milimeter precision. And your attendings will wonder why you dont have them. I had to do a couple CABG with 2.5s while my 3.5 were getting adjusted for depth of field and it was doable but I didnt like it.

 

[Medstart108]

Update, i ended up getting surgitel's 3.5x's, will update when I get to try them, thanks for the advice!

 

[winkyeye]

Can anyone in cardiac surgery speak to how often they use 2.5x vs 3.5x? I have a pair of 2.5x DFV Yeoman loupes but don't like the fit and feel that the clarity is a bit off. I was looking at the Orascoptic EyeZoom Mini and wondering if those would be worthwhile to get so that I can have 2.5x and 3.5x with the same pair. The alternatives I have have been looking at are the DFV 3.5x Panoramic loupes which I am told only comes with the Yeoman frame and the Orascoptic HLD 3.5x.

I tried the DFV 3.5x Panoramic and EF loupes and thought things looked clearer on the EF than Panoramic but I am not sure if that is just because of the specific test samples.

 

[ThoracicGuy]

I went through CT training with only 2.5x and I did fine with it. 3.5x would probably have been nice, but there wasn't anything that I felt I couldn't see. Then again I did a bunch of things during general surgery without anything that I did fine but I had multiple people remark that they were surprised I could see it.

 

[lidlyft]

oculoplastics- just giving a shout out to my Surgitel 2.5x. In love, especially with the light titanium frame and the bomb a** headlight (though expensive).

 

[Dr.LeoSpaceman]

bomb a** headlight (though expensive)

Slight hijack/tangent: What would everyone say is the "best" wireless headlight? Brightness is more important than battery life (to me). I have DFV loupes, but open to change. I'd honestly like to find a light I can wear with loupes or without (e.g. on a second set of loupe frames minus the magnification). Trying to avoid the headband+loupes/protective glasses which I can never get to feel comfortable.

 

[Jolie South]

Slight hijack/tangent: What would everyone say is the "best" wireless headlight? Brightness is more important than battery life (to me). I have DFV loupes, but open to change. I'd honestly like to find a light I can wear with loupes or without (e.g. on a second set of loupe frames minus the magnification). Trying to avoid the headband+loupes/protective glasses which I can never get to feel comfortable.

I have the HD mini from designs for vision with two battery packs. Adds like zero weight and clips on to my Nike loupes. I love it.

 

[mikeGR]

Slight hijack/tangent: What would everyone say is the "best" wireless headlight? Brightness is more important than battery life (to me). I have DFV loupes, but open to change. I'd honestly like to find a light I can wear with loupes or without (e.g. on a second set of loupe frames minus the magnification). Trying to avoid the headband+loupes/protective glasses which I can never get to feel comfortable.

I was looking into this as well, planning to buy once I start my new contract (have the DFV Nike 2.5x loupes). Per the DFV rep:

The price of our Daylite HDI is $1,295. The weight of the optic is 1oz. High intensity is 100,000 LUX. The unit comes complete with 2 power packs. You get 6.5 hours run time on a high and 8.5 hours on medium. The price of our Ultra Mini HDI is $1,295. The weight of the optic is 0.5oz. High intensity is 55,000 LUX. The unit comes complete with 2 power packs. You get 10 hours run time on a high setting and 17 hours on medium. The price of our Twin Beam HDI is $2,295. High intensity is 140,000 LUX. The unit comes complete with 2 power packs. You get 4 hours run time on a high setting and 5.4 hours on medium. This is a dual headlight and would be worn on headset. Please see link below for pictures. Surgical Lighting Systems

All of our new lighting options come with our HDI Universal power packs. These power packs have a simple one touch operation system as well as a smart-link technology to use both power packs at the same time for a long procedure. There is a fuel gauge indicator to keep you up to date on each power pack’s life. When the power pack is left with only 10% charge the optic light will flash to let you know to change out the power pack.

Someone also recommended the Lumadent headlights. They seem to have similar specs to the DVI mini at about half the price. https://lumadent.com/shop/by-category/headlight/prolux-best-value.html

Let us know what you decide and how they feel!

M

 

[droliver]

I'm also in the market for a LED headlight, does anyone have recommendations for a light manufacturer? Ideally something that has a wide light and is long lasting.

I absolutely love this Vorotek headlight. Very light. Great battery life.

Vorotek LED Headlight and Headband | Black & Black Surgical

The Vorotek LED Headlight and Headband is fully integrated and ergonomically designed. Head-worn, lightweight, and hands-free. Purchase now while stocks last!

www.blackandblacksurgical.com

One pro tip as an alternative to lower power loupes (2-3x) is to just get some cheap plastic bifocal safety goggles. They're < $15 and a pretty good substitute for loupes. I like the ones from Dewalt (the power tool company). I haven't used my DFV 2.5x loupes in 15 years. Search on Amazon for:
Dewalt DPG59-130C Reinforcer Rx-Bifocal 3.0

 

[Medstart108]

update: very happy with my surgitel 3.5x. Can't really compare with the other manufacturers but they are lightweight, fit pretty well and vision is clear. The light is strong enough, lasts about 8 hrs continuous use new.

 

[Slack3r]

I absolutely love this Vorotek headlight. Very light. Great battery life.

Vorotek LED Headlight and Headband | Black & Black Surgical

The Vorotek LED Headlight and Headband is fully integrated and ergonomically designed. Head-worn, lightweight, and hands-free. Purchase now while stocks last!

www.blackandblacksurgical.com

One pro tip as an alternative to lower power loupes (2-3x) is to just get some cheap plastic bifocal safety goggles. They're < $15 and a pretty good substitute for loupes. I like the ones from Dewalt (the power tool company). I haven't used my DFV 2.5x loupes in 15 years. Search on Amazon for:
Dewalt DPG59-130C Reinforcer Rx-Bifocal 3.0

How are you using these with such a short focal length? Feel like I have to bend way over to have anything in focus.

 

[droliver]

How are you using these with such a short focal length? Feel like I have to bend way over to have anything in focus.

The working distance is pretty normal to me. Much more natural then with loupes

 

[Dr.LeoSpaceman]

Necrobump on this thread for an update.

I ended up getting a pair of Surgitel 3.0x with the headlight, coming from my original DFV 2.5x. Wish I would have done it sooner. Somehow it seems that I've ended up with wider and longer field of view with more magnification. The working distance adjustment caps are also a nice bonus, as it saves me from having different sets of loupes. I also got rid of the "sport" frame style and went back to the traditional. I always had a hard time looking "around", which isn't an issue with the standard metal frames.

 

[Handinhand]

Bump

I know this thread is a little old, but I wanted to revive it to further discuss loupes, because most stuff written about them is in the dental forum. I currently have Surgitel 2.5s TTL with their Micro LED light. I like the setup well enough, but as will discuss below, I am in need of more cowbell power

Magnification beyond 3.5? Basically, I am in hand surgery and will be doing peds and micro/free tissue. I am trying to decide between having a pair of 3.5s that I use for everything, or a pair of 2.5s that I use for less detailed stuff like fractures/CTR/triggers/etc , and a set of 4.5s that I use for micro/plexus/fine nerve.

Thoughts on TTL vs front mounted? Has anyone either personally or known someone who had their loupes mounted on a headband? I am thinking about moving to front mounted on a hinge that I can flip up out of the way; however, I already don't love the weight of the 2.5s, and get some nose and neck pain. 3.5s and certainly 4.5s will be even heavier, so have been seriously considering head-band mounted loupes. I only know one other surgeon who used headband loupes - a pair of Zeiss - and swore by it, but I'm not sure if I'm missing any glaring negatives with them, otherwise, why wouldn't more people use a headband?

 

[Medstart108]

Bump

I know this thread is a little old, but I wanted to revive it to further discuss loupes, because most stuff written about them is in the dental forum. I currently have Surgitel 2.5s TTL with their Micro LED light. I like the setup well enough, but as will discuss below, I am in need of more cowbell power

Magnification beyond 3.5? Basically, I am in hand surgery and will be doing peds and micro/free tissue. I am trying to decide between having a pair of 3.5s that I use for everything, or a pair of 2.5s that I use for less detailed stuff like fractures/CTR/triggers/etc , and a set of 4.5s that I use for micro/plexus/fine nerve.

Thoughts on TTL vs front mounted? Has anyone either personally or known someone who had their loupes mounted on a headband? I am thinking about moving to front mounted on a hinge that I can flip up out of the way; however, I already don't love the weight of the 2.5s, and get some nose and neck pain. 3.5s and certainly 4.5s will be even heavier, so have been seriously considering head-band mounted loupes. I only know one other surgeon who used headband loupes - a pair of Zeiss - and swore by it, but I'm not sure if I'm missing any glaring negatives with them, otherwise, why wouldn't more people use a headband?

Orascoptic and Examvision have really fancy loupes that can have multiple magnifications in one set of loupes, would consider checking them out if you are thinking you will be using multiple mags frequently.

 

[DrPneumatic]

Bump

I know this thread is a little old, but I wanted to revive it to further discuss loupes, because most stuff written about them is in the dental forum. I currently have Surgitel 2.5s TTL with their Micro LED light. I like the setup well enough, but as will discuss below, I am in need of more cowbell power

Magnification beyond 3.5? Basically, I am in hand surgery and will be doing peds and micro/free tissue. I am trying to decide between having a pair of 3.5s that I use for everything, or a pair of 2.5s that I use for less detailed stuff like fractures/CTR/triggers/etc , and a set of 4.5s that I use for micro/plexus/fine nerve.

Thoughts on TTL vs front mounted? Has anyone either personally or known someone who had their loupes mounted on a headband? I am thinking about moving to front mounted on a hinge that I can flip up out of the way; however, I already don't love the weight of the 2.5s, and get some nose and neck pain. 3.5s and certainly 4.5s will be even heavier, so have been seriously considering head-band mounted loupes. I only know one other surgeon who used headband loupes - a pair of Zeiss - and swore by it, but I'm not sure if I'm missing any glaring negatives with them, otherwise, why wouldn't more people use a headband?

Retina Surgeon in late 40s and now significant presbyopia. Struggling with DFV loupes as weight is killing me. Love the mag and field.
I use them for suturing buckles to the sclera. Also have high glasses script and that wont go into a lighter frame.
Looking for head band mounted loupes to relieve the pain. Any suggestions.