Ocular IVS2 User manual

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OCULAR INSTRUMENTS "IVS2"
INVERTER VITRECTOMY SYSTEM
PRODUCT MANUAL

1
Table of Contents
Page 2 Foreword
Page 3 Safety Information
Page 4 Standard Equipment List
Page 5 Description of the IVS2 and its Functions
Proper Use
Page 6 Figure 1 –IVS2 and its Components
Page 7 Using the IVS2 for the First Time
Attachment to an Operating Microscope
Page 8-11 Illustrations of IVS2 on Various Microscopes
Page 12 Transport of the IVS2
Using the IVS2
Before each use
Practical Tips on using the IVS2
Page 13 Maintenance
Removable Accessories
Care, Cleaning and Disinfection of the IVS2
Sterilization of the Adjustment Knob
Page 14 Troubleshooting
Page 15 Guarantee
Limitations of Liability for Malfunction or Damage
Service Address
Page 16 Declaration of Conformity
Technical Data
Page 17-20 Autoclavable Wide Angle Inverted Image Contact Lenses
Description
Technique
Product Care
Page 21-24 Non-Autoclavable Wide Angle Inverted Image Contact Lenses
Description
Technique
Product Care
Page 25-26 Landers Four Post Vitrectomy Lens Ring
Description
Technique
Product Care

2
Foreword
Ocular Instruments would like to thank you for your purchase of another fine
product from our company. In choosing the IVS2, you have acquired a modern
product using the latest technology in its field. You can be assured it has been
manufactured and tested to the most stringent quality requirements.
Ocular Instruments has been manufacturing fine optical products for over forty
years. We offer only products of the highest quality for use in diagnosis and
treatment of diseases and disorders of the eye.
The Inverter Vitrectomy System re-inverts the inverted image of our line of
Wide Angle Vitrectomy Lenses.
Proper installation and care of the device is indispensable for accurate and safe
use. For this reason, please familiarize yourself thoroughly with the contents of
this instruction manual before putting the instrument into use for the first time.
If you have questions or would like additional information, please either
contact us directly or our distributor from whom you have purchased our
product. Our service team will be most happy to assist you.
Sincerely yours,
The Management and Staff
Ocular Instruments, Inc.

3
Safety Information
Please keep these operating instructions in a secure place. Always observe
these operating instructions when working with the surgical operating
microscope and related equipment. The IVS2 may be used only for purposes
named in the instruction manual and only by persons who have been properly
trained.
Use this instrument only with original manufacturer’s parts and accessories and
in technically flawless working condition. Do not use the IVS2 if it is
defective. Please contact Ocular Instruments or its distributor if you believe the
unit to be defective.
Do not use the IVS2 in the presence of volatile solvents such as alcohol,
benzene or the like.
This unit is an excellent quality and highly technical product. Should a
malfunction occur whose cause you cannot locate or eliminate with the
Troubleshooting Table in this manual, please mark the unit clearly as non-
operational and contact our customer service department at 800-888-6616 (toll
free USA), or 425-455-5200, or email to: [e-mail].

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Standard Equipment List
1 IVS with 2 protective dust covers (OIVS2L or OIVS2Z)
1 Rubber Adjustment Knob (OIVS2-K) steam sterilizable
1 Carrying Case with foam liner (OIVS2-C)
1 Screw Driver
1 Instruction Manual (Part 11151)
IVS2 Set also includes a combination of the following steam
sterilizablelenses:
1 Landers Wide Field Vitrectomy Lens (OLIV-WF)
1 Landers Equatorial II Vitrectomy Lens (OLIV-EQ-2)
1 Woldoff High Magnification Vitrectomy Lens (OWIV-HM)
OR a combination of the following non-autoclavable lenses:
1 Landers Non-Autoclavable Wide Field Vitrectomy Lens
(OLIV-WFNA)
1 Landers Non-Autoclavable Equatorial Vitrectomy Lens
(OLIV-EQNA)
1 Woldoff Non-Autoclavable High Mag. Vitrectomy Lens
(OWIV-HMNA)
plus:
1 Landers Four Post Vitrectomy Lens Ring (OLV-1/4P)
2Lens Holding Handles (OLIV-H)
1Autoclavable Lens Cleaning Cloth (OLCCA)
We reserve the right to make technological
improvements in the IVS2 without prior notice.

5
Description of the IVS2 and its Functions
Vitreous surgery is often carried out with plano-concave lenses, biconcave
lenses and wide field lenses. Combination contact lens systems and indirect
ophthalmology lenses provide an even greater field of view of the fundus.
However, the image they provide is inverted which is extremely difficult to use
during vitreous surgery.
The IVS2 re-inverts the image of the contact lens systems such as those made
by Ocular Instruments. It frees the surgeon's hands and allows him to work in
the vitreous with an upright, non-reversed image under panoramic conditions.
During surgery, operative work is performed both outside and inside the globe.
Since the fundus is observed through a contact lens, it is necessary to be able to
move back and forth smoothly and quickly between the upright and the
inverted image. This function is performed by the IVS2.
The IVS2 consists of an optical system which can be rotated into the optical
path of the microscope to produce a complete image re-inversion. The image
inversion can be turned on and off by turning the adjustment knob (Figure 1,
No. 3) capped with the rubber adjustment knob (Figure 1, No. 4) clockwise
until it clicks into position. The position of the optical system is noted by the
indicator in the glass window (Figure 1, No. 7). It is centrally located on the
front of the IVS2 just to the left of the adjustment knob. If the image in the
window is yellow, the optical system has been swung to the side and image
inversion is not occurring. The “O” indicates the image inversion is inactive.

6
Proper Use
The IVS2 is part of a microsurgical operating system which is intended only
for use as described in this instruction manual. It is intended for surgery in the
posterior segment of the human eye and should be used only by physicians who
have been trained, have the knowledge and experience to ensure proper
handling.
The IVS2 is intended for use with operating microscopes in hospitals, clinics,
outpatient facilities etc. where ophthalmic surgery is performed. Such operating
microscopes must be specifically designated by Ocular Instruments as being
compatible with the IVS2.
Use this instrument only with original parts and accessories delivered by our
authorized distributor or us and only when it is in perfect condition.

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Figure 1 - The IVS2 and its Components
No. 1
Protective dust cover
No. 4
Rubber Adjustment Knob
(sterilizable)
Cap for adjustment knob No. 3 above
No. 2
Knurled thumb screw
Fastens upper part of
microscope to the
IVS2.
No. 5
Protective dust cover
No. 3
Adjustment knob
No. 6
Rating plate
Manually operated
No. 7
Indicator Window (transparent glass)
1
2
3
4
5
6
7

8
Using the IVS for the First Time
Remove the IVS2 from its carrying case. Please keep the carrying case
available for storage, if necessary and for possible shipment during servicing.
As part of a very expensive optical system, the IVS2, like the operating
microscope, should be handled with care and should not be subjected to shocks,
high temperature, moisture or fluids or high temperatures (above 40° C).
Before assembling the IVS2 and microscope, remove both protective dust
covers and store them in the carrying case. The upper one (Figure 1, No. 1)
may be removed by unscrewing the knurled thumbscrew (Figure 1, No. 2), and
the lower one (Figure 1, No. 5) can be simply pulled off.

9
Attachment to an Operating Microscope
Always take care when mounting or removing the IVS2 that none of the optics
in the beam path become soiled. In order to mount the IVS2 on your operating
microscope, unscrew the locking screw on the main body of the microscope
(Figure 2, No. 1) with the screwdriver provided. Remove the binocular
eyepiece assembly and the beam splitter from the main body of the microscope.
On many microscopes, the beam splitter is permanently built into the
microscope; in this case, the IVS2 must be mounted above the beam splitter.
Figure 2 –Microscope Before Installation of IVS2
No. 1 Microscope Locking Screw
1

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Now place the flange of the IVS2 into the dovetail receptacle of the main body
of the microscope. Check that the IVS2 is properly seated before carefully
tightening the locking screw on the main body of the microscope (Fig 3, No.
1). When properly mounted, the IVS2 should not wobble. Make sure of this
before attaching the other microscope components.
Proceed in the same manner when mounting the beam splitter, the binocular
eyepiece and other components of the microscope; that is, carefully tighten the
knurled thumb screw of the IVS2 (Fig 1, No. 2) in the same manner and then
confirm that each component is correctly seated.
Figure 3 - Microscope After Installation of IVS2
No. 1 Microscope Locking Screw
If an endolaser is used, the laser shutter can be positioned either between the
main body of the microscope and the IVS2 or between the IVS2 and the beam
splitter.
A separate eye protector for the assistant must be provided if the laser
shutter can only be positioned above the beam splitter.
When using a laser, always follow the instructions of the laser manufacturer.
1

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Illustrations of IVS2 on Various Microscopes
Zeiss Microscope

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Leica (Wild) Microscope

13
Topcon Microscope

14
Using the IVS2
Before Each Use
Before every use, be sure that:
•The unit is in good working order.
•All connections are secure.
•If a binocular eyepiece is use with swivel-mounted tubes, we recommend
adjusting the angle to between 30° and 45°. Experience has shown this
permits the user to sit more comfortably.
Practical Tips on Using the IVS2
Adjustment of the IVS2 optical system is accomplished by rotating the
sterilizable Rubber Adjustment Knob (OIVS2-K) either clockwise or
counterclockwise to its other position. Always activate the IVS2 if you are
using optical inversion; e.g., with Ocular Instruments steam sterilizable or non-
autoclavable wide angle inversion vitrectomy lenses.
If you are using non-inverting lenses, e.g., Landers High Refractive Index
Vitrectomy Lenses, the IVS2 inverting system must be in the off mode. Simply
rotate the Rubber Adjustment Knob until a yellow “O” appears in the window
(Figure 1, No. 7).
Installation of the IVS2 lengthens the microscope body only slightly.
Therefore, it can remain on the microscope during anterior eye segment and
cataract procedures.

15
Maintenance
Removable Accessories
The adjustment knob (Figure 1, No. 3) is fix mounted in the IVS. When
removing the rubber sterilizable cap (Figure 1, No. 4), simply pull it off
gradually with care.
Care, Cleaning and Disinfection
Do not clean the IVS2 with agents which are aggressive, abrasive, contain
chlorine or attack the finish of the unit. Do not allow any liquids to come in
contact with the optical elements inside the IVS2. The outer surfaces of the
IVS2 may be cleaned by wiping with a damp cloth. Remove any residues with
a mixture of equal parts of alcohol and distilled water.
Sterilization of the Adjustment Knob
Only the rubber cap needs to be sterilized, if it is used. The rubber cap is steam
autoclavable at 270°F (132°C) for the appropriate time period per your
sterilizer’s instructions.
Transport of the IVS2
Always position the optical system of the IVS2 in one of the two rest positions.
Only then is the optical system properly immobilized. Avoid impacts when
moving the IVS2 to another location, since this can have an adverse affect on
the calibration of the device. Inspect the system after moving the microscope to
make sure it is in good working order. When transporting separately, avoid
unnecessary damage and costs, by transporting the IVS2 unit in its carrying
case.
Do not keep the IVS2 in a cold storage area or leave it in a vehicle during the
cold months of the year. The optics can become fogged following wide ranging
changes in temperature from cold to warm. Should this occur, give the IVS2
time to adapt to the conditions of its new location before putting it into
operation.

16
Troubleshooting
Should a problem arise which you cannot correct by using the trouble shooting
table below, please label the IVS2 clearly as non-operational and call our
service department or that of your local distributor from whom you purchased
the IVS2.
Problem
Possible Cause
Corrective Measures
Poor Image Quality
The glass surfaces of the
IVS2 or the contact
lenses are soiled.
The IVS2 glass surfaces can
only be cleaned by Ocular
Instruments.
Image is distorted
The IVS2 is mounted at
an angle.
Mount the IVS2 correctly.
IVS2wobbles
The locking screws are
loose.
Tighten the knurled screws on
the IVS2 and microscope.
Pronounced reflections on
the contact lens
The microscope
illumination is turned on.
Turn off the illumination and/or
tilt the contact lens slightly.
Seeing surgeon's hand
movements outside the
image of the eye, causes
nausea.
The IVS2 inverts all of
the images that come into
the microscope. Since
the wide angle lenses
invert the image of the
fundus and vitreous, the
IVS2 turns the image
upright to its correct
orientation. On the other
hand, the lens housing
and the doctors hands and
everything outside the
eye will appear inverted
and will move in the
opposite direction that
you would expect.
Increase the magnification of
the microscope so that the only
image seen is the inside of the
eye that is produced by the lens.
It may still be a little problem
that they can see the lens
housing moving in the opposite
direction but after a little
experience, the feeling of
nausea should go away.
The most important thing is that
the microscope field of view is
small enough that the surgeons
cannot see their hands or the
instruments where they are
outside the eye. Then
everything will look and feel
correct.

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Guarantee
The IVS2 was carefully manufactured from the highest quality materials
available and with modern production techniques. To keep the IVS2 in perfect
working condition, it is important these operating instructions be followed.
The IVS2 is unconditionally guaranteed against defects in materials and
workmanship within one year of invoice date. Problems or malfunctions caused
by improper handling or external causes are not covered by the warranty. The
IVS2 should only be serviced by a factory trained technician. Should you
encounter a problem, please return it to Ocular Instruments in it’s carrying case
with both protection caps covering the optics.
Proof of purchase and a copy of the original packing slip are required before
services can be provided under the guarantee. Please call Ocular Instruments to
obtain a Return Goods Authorization number prior to returning the IVS2. It is
recommended that all shipments to Ocular Instruments be made via UPS,
prepaid and insured for full value.
All guarantee claims are cancelled if the IVS2 is altered by an unauthorized
person.
Please report any shipping damage immediately to your shipping company if
the unit is received in a damaged condition. Many times the shipping company
will not approve a claim if the damage is not reported immediately upon
receipt.

18
Limitations of Liability for Malfunction or Damage
Ocular Instruments accepts responsibility for the safety, reliability and
serviceability of the IVS2 only if the IVS2 is used in accordance with these
operating instructions. All liability of Ocular Instruments ceases to exist if
assembly work, additions, adjustments, overhauls, changes or repairs are made
by unauthorized persons or if the unit is improperly serviced or handled.
Service Address
Supplementary information is available from our service department or from
our authorized representatives. See the rating plate label on the back side of the
IVS2 for the serial number. This should always be listed in all correspondence.
Ocular Instruments, Inc.
2255 116th Avenue NE
Bellevue WA 98004-3039
USA
Phone: [phone]
Toll Free: 800-888-6616
Fax: [phone]
E-mail: [e-mail]
Internet: www.ocularinc.com