Brod R D, Olsen K R, Ball S F, Packer A J
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida.
Am J Ophthalmol. 1989 Apr 15;107(4):390-7. doi: 10.1016/0002-9394(89)90662-4.
We determined the site of the focal illumination from the Zeiss OPMI-6 operating microscope on the retina of the phakic and aphakic human cadaver eye by directly observing the illuminating element image on the posterior scleral surface of the globe. With the eye straight ahead and the operating microscope level, the focal oval area of retinal illumination was located superior to the foveola in both the phakic and aphakic eye. Tilting the operating microscope 10 degrees toward the surgeon displaced the entire illuminating element image 0.50 mm below the foveola in the phakic eye and 0.25 mm below the foveola in the aphakic eye. Rotating the eye inferiorly 10 degrees displaced the entire illuminating element image 1.0 mm below the foveola in the phakic eye and 1.25 mm below the foveola in the aphakic eye. Centering the field of view superiorly (viewing the superior limbus) paradoxically displaced the illuminating element image inferiorly, resulting in central foveal illumination. Foveal light exposure was avoided in most eye positions by tilting the microscope at least 10 degrees toward the surgeon.
我们通过直接观察眼球后巩膜表面的照明元件图像，确定了蔡司OPMI - 6手术显微镜在有晶状体和无晶状体人尸体眼视网膜上的聚焦照明部位。当眼睛直视前方且手术显微镜处于水平状态时，有晶状体眼和无晶状体眼中视网膜照明的聚焦椭圆形区域均位于黄斑小凹上方。将手术显微镜向外科医生倾斜10度时，有晶状体眼中整个照明元件图像会移至黄斑小凹下方0.50毫米处，无晶状体眼中则移至黄斑小凹下方0.25毫米处。将眼球向下旋转10度时，有晶状体眼中整个照明元件图像会移至黄斑小凹下方1.0毫米处，无晶状体眼中则移至黄斑小凹下方1.25毫米处。将视野向上居中（观察上睑缘）时，照明元件图像反而会向下移动，从而实现中央凹照明。在大多数眼位中，通过将显微镜至少向外科医生倾斜10度可避免黄斑小凹受光照射。
