“The Perfect Flanger (Rumex 4-211T) is a forceps made of titanium which has a 150 μm deep groove (75 μm for each arm) at the grasping end, combined with a 1 mm long reference cylinder attached to it. Having a grooved grasping end allows for a gentle way of holding the haptics, thus diminishing the possibility of an unwanted trauma. This is especially important when holding poly(methylmethacrylate) (PMMA) haptics, which tend to kink more easily than polyvinyl fluoride (PVDF) ones, making it impossible to continue the surgery in a safe manner when it happens. In addition, having a 1 mm reference cylinder saves surgery time by sparing the need for several measurements with different tools such as a caliper, professional ruler, or ink markers to assure the correct distance between the haptic tip and the forceps holding it.”
The Rumex 20-061 double-ended femto-phaco spatula was very useful for me even in non-femto-assisted cataract surgeries, as an off-label use of this instrument. In these complex conventional phaco procedures, without the use of the femtosecond laser, it permitted a very fine and gentle synechiolysis with its finest tip in cases of extensive uveitic cataract surgeries, which was not possible with other regular spatulas available in the operating room, which had bigger and larger tips, which were not adequate for the fine and gentle dissection and release of posterior synechiae that I needed, specially in cases of poor visualization of the anterior segment due to corneal pathology. It permitted a very gentle and minor release of extensive posterior synechiae with its finest tip in cases of uveitic cataracts with extensive posterior synechiae with no trauma to the lens capsule, permitting a safer surgery. It was easy to use this instrument even throw a 0,7mm side port, allowing a complete 360º bimanual manipulation throw both main and side ports without induction of cornea striae. The use of this instrument was a very pleasant experience and it is very nice to have it in my surgical trays to be available when I need it.
October, the 14th, 2022
Ivo Filipe Gama, MD Portugal Trofa Saúde Health Group
The Escaf pre-chopper permits to fracture the nucleus of cataract with several grades (< grade 4), without the use of ultrasound, permitting to minimize the total amount of ultrasound energy used in the surgery, protecting the corneal endothelium. This is specially useful in cases of low corneal endothelial counts. This pre-chopper is safer than other pre-choppers in cases with small rhexis, because of its round edges. It also allows its use through a main clear corneal incision of 2.0mm, with great mobility thought such a small incision, preserving the anterior chamber stability. This instrument permits the mechanical fracture of the nucleus without the need to place metallic instruments at the lens equator, being safer to preserve the capsule, specially in cases with poorer visualization of the anterior segment due to corneal pathology. Additionally, I found this instrument very useful even in cases of total cataracts because it facilitates the separation of the two hemi-nucleus after performing the main groove with ultrasound, and even further to further divide the nucleus in smaller pieces after grooving, reducing the time spent to split the nuclear pieces. I think that this is an instrument that must be present in any cataract surgical tray.
“Makes precise and stable cuts of the cataract, which gives the surgeon a lot of security when performing the surgery. The most interesting thing about it is the oval shape of the back of the instrument, which allows mobilization of the iris in the cases that are required”
"We’ve been working with RUMEX International for quite a few years now and in all of that time we’ve never ordered an instrument that has let us down. I have been able to complete my kits with less expensive but high quality ophthalmic instruments. Our Transplant Laboratory mainly use RUMEX instruments for precise endothelial grafts preparation. I and my colleagues are happy with titanium and high grade steel instruments for keratoplasty such as forceps, calipers, needle holders and disposable corneal blades. I would, and have, recommend you RUMEX instruments to anyone. I truly enjoy working with the staff at RUMEX International and the speed they provide me with new requests and purchases".
All forceps terminals are sharp enough to rupture the capsule without problem. The only observation in my opinion is they should be thinner in overall length, 110 mm, that way will be much better for small incisions.
The handles аге very good quality, maybe you can make smaller ones, more options to choose from.
I used the instrument in a proliferative diabetic retinopathy with vitreous hemorrhage and retinal detachment case. I was already familiar with the Rumex line of instruments so the feel of it in my hands were great. It was very maneuverable through a trocar and I could easily reach even the peripheral area.
It had enough stiffness so it doesn’t easily bend with more aggressive moves, a problem I have with some disposable instruments, especially those with smaller gauges. The visibility of the instrument is good, the reflections against the light pipe were minimized. The gripping action against the membranes were precise and solid, so I was able to elevate the membranes easily and able to stop once I know that neofibrovascular bleeding might occur. A safe and more extensive membrane peeling was done through this instrument. I like the textured finish of the titanium handle and its round shape that fits my fingers ergonomically and prevents slippage against my surgical gloves. Offhand, I would say that it is a very reliable and versatile instrument and I would recommend it to all vitreoretinal surgeons.