Alcon’s Finesse Reflex Handle is designed to help vitreoretinal surgeons move with ease, providing unrestricted movement and intentional, focused performance.

“I was excited to try the Reflex Handle because of its smaller basket handle and smaller overall instrument size,” says Lori Coors, MD, a retinal physician and partner at Texas Retina Associates in Dallas, Texas. “Being able to feel a groove closer to the instrument’s shaft allows for better control of the forceps’ tips. I can rotate the tips 360 degrees inside the eye by just slightly moving my fingertips.”

David R.P. Almeida, MD, PhD, MBA, vitreoretinal surgeon and director of clinical and surgical research at Erie Retinal Surgery & Erie Retina Research in Pennsylvania, appreciates the Reflex Handle’s versatility. He can use it for macular cases (eg, epimacular membranes and macular holes) as well as in advanced pathology (eg, proliferative vitreoretinopathy epiretinal membranes), which eliminates the need for redundant retinal equipment. This supports operating room efficiency.

HOW IT WORKS

The Reflex Handle was created with feedback from surgeons who wanted improved precision performance when addressing delicate tissue and pathology. “The Reflex Handle is a result of more than 6 years of thoughtful research, design, and testing to create an instrument that can deliver precision performance during surgery,” says Josh Anderson, MBA, head of sales and marketing, Surgical Retina, Alcon Vision LLC.

Compared to the Reflex Handle’s predecessor — Alcon’s Grieshaber Revolution — the new instrument is smaller in diameter, shorter in length, and easier to control during rotation, Dr. Coors says. The new hand piece is lighter and stiffer, which allows for better control when moving the forceps.

Closing the forceps only requires minimal pressure from the fingers thanks to Reflex Handle’s smaller basket, which is more comfortable and secure for surgeons, Dr. Coors says. The new instrument also has a shorter handle than the Revolution, which improves the ability to peel membranes at a steep angle such as in long eyes or when removing peripheral membranes.

Other forceps use a hand piece with a clam shell closure mechanism, which is often quite long and requires significant hand movement to change the forceps’ orientation, Dr. Coors says. This reduces stability when peeling and can require removing the instrument from the eye to safely reorient the forceps’ direction.

Dr. Almeida says the Reflex Handle’s wider levers allow for an increased surface area connecting to the instrument handle. “The latter has no equal when comparing it to other available retinal forceps,” he says.

CLINICAL APPLICATIONS

Finesse Reflex products are standalone instruments that can be used independently or in conjunction with other Grieshaber instrument types in 25 gauge and 27 gauge, including the Reflex Sharkskin ILM forceps, Reflex Endgrasping forceps, and Reflex Maxgrip forceps, Anderson says. These products are all used to peel different membranes from the retina’s surface.

Dr. Coors performs all epiretinal membrane peels and macular hole surgeries with the Reflex Sharkskin ILM forceps, which have a rasp-like, texturized surface on the tips’ platform which enable her to engage tissue easily by resting the tips on the retina’s surface.

“This allows for less traumatic peeling of membranes because the forceps can engage a membrane or ILM with only gentle pressure on the retina rather than pinching or pressing into retina tissue to try to snag an edge,” Dr. Coors says. “I can then use the Reflex Handle to easily rotate the forceps to engage membranes without removing the instrument from the eye during peeling.”

Dr. Coors uses the Reflex Maxgrip forceps for peeling proliferative vitreoretinopathy membranes and removing dislocated intraocular lenses, and has even used them to engage small intraocular foreign bodies. The Reflex Handle’s smooth action allows for safe and precise removal of membranes and the stiffer shaft allows for easier rotation of dislocated intraocular lenses into the anterior chamber for removal or repositioning.

The Reflex Handle and Reflex Sharkskin ILM forceps are Dr. Almeida’s standard forceps for almost all retinal and macular cases. He uses pinch-and-peel membranectomy techniques for macular cases such as epimacular membranes and macular holes. The Reflex Handle and the Reflex Sharkskin ILM forceps are also ideal for advanced pathology cases such as proliferative vitreoretinopathy, where the instrument’s precision is critical to the sometimes tricky membranectomy in detached retina.

HOW PATIENTS BENEFIT

Peeling procedures are some of the most delicate work performed by vitreoretinal surgeons. “Providing instrumentation that combines enhanced user ergonomics with precision peeling technology assists in the execution of surgical tasks, which benefits patients,” Anderson says.

Reflex products improve the ability of surgeons to precisely engage delicate tissue, such as ILM, and to efficiently reposition the forceps’ tips without removing the instrument from the eye. “This improves efficiency and reduces time required to perform membrane peels,” Dr. Coors says. “It also improves patient safety because there is less chance for the retina to be injured due to the instrument’s more precise control and less of a need to remove instruments from the eye to reposition the forceps, which can be associated with increased risk of peripheral retinal tears.” RP