Product Evaluation: Zeiss Stemi DV4 to Meiji or 4X Loupes
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* William H. Reed

1.  William H. Reed, MD
    1.  La Jolla, California

This column is intended to help each of us accelerate the evolution of our individual approaches to our surgical techniques. Bless my mother, but one adage throughout my youth was, “‘Tis a poor craftsman who blames his tools.” It was literally decades before I indulged myself sufficiently to question her wisdom. Nowhere are the limitations of this wisdom more apparent than in the tools of hair transplantation. I am indebted to my colleagues for sharing their tips and tools. Such sharing is one of the most valuable aspects of attending meetings regularly. If some of you have a recommendation of an instrument, I would appreciate your letting me know so we can share it with others.

## Magnification Tools

At one time I was opposed to the microscope. I thought it was like driving a Ferrari on city streets, i.e., expensive and sexy but the wrong tool for the task at hand. I thought I had an understanding of the product. I had used a Meiji and had even modified it with a ringed, fluorescent light source. My technicians and I didn’t see a benefit of this product compared to 4X loupes. After being introduced to the Zeiss Stemi DV4 stereoscopic dissecting microscope, our opinion has unanimously switched to favor this microscope. It is the only form of magnification we use currently for slivering or for graft production from slivers or 2mm strips.

Four technicians were asked to compare the Meiji, the Zeiss Stemi DV4, and 4X loupes with respect to the below parameters. It should be noted that all technicians were very experienced and the assessments may be different for technicians early on their learning curve. The following table is a rating of the technicians regarding important qualities of the dissection experience. The best tool for any parameter is given a 10 rating with the other two tools given an appropriately lower rating. This study is not meant to have any merit from its scientific method; it is only meant to encourage you to arrive at your own conclusions. I have no commercial interest in any of these products.

Some of you like the Mantis microscope. I have limited experience with it but can believe that it has superior postural comfort and ease of keeping the dissecting field in view. The ease of going from the magnified field to look directly at the tissue is also a nice feature that should help minimize fatigue and maximize efficiency. However, I would not think it capable of the optical parameters that are obtained with the Zeiss/Meiji that are “plugged into your eyeballs” as much as is physiologically possible. Arguably, such optical clarity is unnecessary, however.

The ease of hand/eye coordination and the ease of keeping the dissecting field in view can argue for the use of loupes in the early stages of the technician’s learning curve. In the final analysis, it is for the individual craftsman to choose her or his tool to maximize the comfort, speed, and quality of her or his grafts.

![Figure1](http://www.ISHRS-HTForum.org/https://www.ishrs-htforum.org/content/htfi/12/4/144/F1.medium.gif)

[Figure1](http://www.ISHRS-HTForum.org/content/12/4/144/F1)

*   Copyright © 2002 by The International Society of Hair Restoration Surgery