New speculum optimizes surgical field

A new speculum (Brown Triple-Post Speculum, Rhein Medical) can help make cataract and refractive surgery easier and safer to perform, said Reay H. Brown, MD, designer of the instrument.

Key Points

In contrast to most lid specula that have two posts and open the eye to a square or rectangular shape, the triple-post speculum-with its extra middle post-exposes the eye in a more ideal circular or oval configuration.

"When surgery is [performed with the patient] under topical anesthesia, there may be a tendency for the eye to rotate up as a result of Bell's phenomenon," Dr. Brown said. "Often, that makes no difference technically because the area of exposure is sufficiently large. However, in some patients with smaller or deeper-set eyes, gaining the extra exposure superiorly by lifting the center portion of the upper lid with a third post really can facilitate the surgery."