Head support for the patient during ophthalmic microsurgery.

The increasing use of the binocular operating microscope in ophthalmic surgery has highlighted both the desirability of some form of support for the operating surgeon's arms and the need for better fixation of the patient's head. Arm rests attached to the operating chair (Barraquer and Boberg-Ans, I959) or to the operating table (Pierse, I969) have been described. A more sophisticated mobile arm rest which maintains complete support of forearms and wrists has been described by Henderson, Pericic, and O'Brien (1970), who pointed out that hand tremor limits the finesse of microsurgical manoeuvres, and that, when using the operating microscope, the surgeon's arms and hands are necessarily in such a position that hand tremor will soon develop unless complete and comfortable support of the forearms and wrists is obtained. Various devices have been described for supporting the patient's head, of which one in common use is the Ruben Pillow (Ruben, I959). A device which would both support the patient's head and provide hand support for the surgeon was felt to have some advantage. It is interesting to note that Dekking (1956), one of the early advocates of microsurgery, described such a support in prototype stage.