Hans Geuder senior was born when Kaiser Wilhelm II still ruled in Germany and Theodore Roosevelt served as the president of the United States.
Hans Geuder senior begins to manufacture surgical instruments in Heidelberg (Germany) as a fellow craftsman and later as a master craftsman and trainer.
Hans Geuder junior (left) was born.
Volker Geuder (left) was born.
H. Harms (Tübingen, Germany) invents the running suture for keratoplasty. For this demanding procedure, the Hans Geuder company has been producing the finest atraumatic antimagnetic keratoplasty and corneal needles as well as matching needle holders and forceps since the 1960s. It was not until 1981 that F. Hoffmann developed the double running cross-stitch suture, where sutures cross over in the area of the wound gap and thus ensure a watertight wound closure. In 2018, S. Suffo perfects the penetrating keratoplasty (PK) with the Homburg corneal marker in collaboration with Geuder.
H. Ridley implants the first IOL made of acrylic glass (PMMA). He became aware of the biocompatibility of the material by noticing during the Second World War that splinters from destroyed cockpit windows of fighter planes did not cause a foreign body reaction in the eyes of injured pilots. Thus, he is considered the inventor of the first IOL. It takes almost 10 years until IOLs are mass-produced and recognised by the medical profession as a therapeutic procedure. Geuder supports this innovation early on with special implantation forceps.
E. Custodis successfully treats a retinal detachment for the first time with an epi-scleral buckle. C. Schepens and A. Arruga introduced the cerclage technique in 1957. Thus the foundation stone of modern buckling is laid. To this day, Geuder offers a very broad portfolio of implants and instruments for buckling surgery, which has certain advantages over vitrectomy, especially in younger patients, because, as an extraocular procedure, it does not induce cataract and preserves the natural accommodation of the lens.
The German Ophthalmic Society (DOG), founded in Heidelberg (Germany), is the oldest scientific medical society in the world. On the occasion of the 100th anniversary of the DOG, Hans Geuder senior and junior present their ophthalmic surgical precision instruments at the 62nd annual conference in Heidelberg.
In the 1960s, S.N. Fyodorov further develops T. Sato's Radial Keratotomy (RK), but confines himself to epi-corneal incisions to avoid complications caused by the endo-corneal incisions of Sato's technique. Fyodorov does not apply his developments until the late 1970s. Geuder follows the history of refractive surgery with Sato knives, corneal markers and diamond knives, among others, up to modern LASIK instruments.
José Barraquer, the "father of modern refractive surgery", develops lamellar techniques including keratomileusis and keratophakia, as well as the first micro-keratome (corneal micro-lathe). Until the introduction of the motorized MIKRO-KERATRON micro-keratome in 1978 and thereafter, manual trephines remained the method of choice for many applications. Geuder has been known for its broad portfolio of particularly precise and sharp trephines since the 1960s.
C. Kelman develops the procedure of phacoemulsification, which emulsifies and aspirates cataracts by means of ultrasound. As phacoemulsification did not enter clinical routine in Germany until the 1980s, Geuder launched its first ultrasound generator, the PHACO U-S, in 1983. Phacoemulsification allows smaller incisions, resulting in faster wound healing and visual recovery, as well as reducing wound leakage and unintentional filter pads.
Trabeculectomy, introduced by J. Cairns and P. Watson, is the most performed surgery worldwide for the treatment of chronic open-angle glaucoma. For opening the scleral flap and Schlemm's canal, Geuder offers appropriate markers and knives early on. Characteristic of this operation is the so-called "filter bleb", which is created by the accumulation of aqueous humour under the conjunctiva.
Geuder GmbH moves to Heidelberg-Rohrbach (Germany) into a larger and more modern building, which was expanded in the following years.
At the end of the 70s, air injection lancets are used for thin paracenteses and air injection cannulas for pressurizing the eyes. Geuder develops the successful Sautter cannula.
H. Sautter was appointed to the chair of ophthalmology at Hamburg University (Germany) in 1953. He was an honorary member of a number of national and international scientific societies and was a member of the board of the German Ophthalmological Society (DOG) for several years. His book on the morphology of lens opacities remains a core literature, and he also published two atlases on diseases of the fundus of the eye. He was editor of the journals "Advances in Ophthalmology" and "Ophthalmologica" for many years.
With the MIKRO-KERATRON®, Geuder, in cooperation with Prof. G.O.H. Naumann (Erlangen, Germany) and Prof. U. Demeler (Hamburg), launch the first motorized trephine with optical control for motor-controlled cutting of the corneal flap. The precision of the cuts is thus many times higher than with the manual trephines used up to now.
M.U. Dardenne of the university hospital Bonn (Germany) is almost expelled from the German Ophthalmic Society (DOG) for introducing phacoemulsification into German cataract surgery, but he receives the Federal Cross of Merit in 1985 for his scientific achievements. Prof. Dardenne (right) is in this picture in company with S.N. Fyodorov (4th from right) and former Foreign Minister Hans-Dietrich Genscher (6th from right) as well as the Geuder brothers (in the background).
In collaboration with W. Papst (Hamburg, Germany), Geuder develops the ASPITRON®, an electronically controlled peristaltic pump for extracapsular cataract extraction (ECCE). Aspiration and irrigation are controlled with a foot switch, which allows cortical debris to be removed in a more controlled manner than it was possible with the syringes used until now. This reduces the risk of capsular rupture.
The PHACO U-S is a 43 kHz ultrasound generator with integrated infusion connection and vacuum-controlled aspiration for connection to the PHACO-ASPITRON® I/A-System. A test program for checking the ultrasound power can detect errors such as an ultrasound tip that is not firmly attached. The unit has an optional pulsed ultrasound of 1-10/sec and a maximum longitudinal stroke of 85 μm as well as a digital display for the ultrasound time or the product of time x power. The ultrasound power can be switched on and off via a foot switch and is linearly adjustable. The piezoceramic air-cooled handle has a low weight of only 89 g.
Almost at the same time with the introduction of capsulorhexis by Gimbel and Tobias Neuhann, R. Adamczyk (Munich, Germany), together with Geuder, developed a magnet-driven capsulotome for precise perforation of the anterior lens capsule.
The PHACO-ASPITRON® I/A for cataract surgery is a further development of the pure irrigation and aspiration unit, which also allows the manually controlled small incision technique for use in the anterior segment of the eye (approx. 3.2 mm). The device was developed together with Professors M.U. Dardenne and H.-R. Koch from Bonn (Germany).
The PHACO-ASPITRON® I/A is a combination of the individual devices PHACO and ASPITRON. This system could be extended by the DIATHRON diathermy unit and the LUXATRON light source (or combination of both units DIATHRON-LUXATRON). Geuder was one of the first suppliers of complete modular systems.
With the MAGNETRON, an electronic control unit for magnetic and motorized instruments, Geuder introduces a vitrectomy machine for the first time. Via an 8-position step switch, vitrectomy and vitreous/retinal switching programs can be selected to control the magnetic VITREOTOME and VITREOUS-CUTTER. The pulse speed can be adjusted by a potentiometer or foot switch up to the value preset on the digital display. Vitrectomy is used as a newly established procedure for the removal of epiretinal glioses in 1978 and pars plana vitrectomy for the first time in 1991 for macular holes, but vitrectomy was invented as early as 1971. R. Machemer revolutionized vitreous and retinal surgery with it by largely eliminating the pressure drop in the eye and reducing the complication rate through a closed system.
The MAGNETRON was also able to control motor trephines with a cutting speed of 0-500 rpm. Even at low cutting speeds of, for example, 20 rpm, cutting was just as powerful as at high rotation speeds because the slow-down effect acting on the cutting edge is automatically readjusted by an increased current voltage supply to the motor to counteract a drop in torque.
The sons of Hans Geuder senior take over the business:
Son Volker as Technical Director and son Hans junior as Commercial Director.
LUXATRON light source and DIATHRON diathermy device. The LUXATRON is used for intraocular illumination and thus becomes the preceding model of the later developed XENOTRON devices and most recently the SOLEA®.
The DIATHRON is used for the coagulation of bleeding. A special feature of the DIATHRON is that it can be controlled by the foot switch of the PHACO-ASPITRON and the surgeon does not need an additional foot pedal.
The company building in Heidelberg (Germany) is equipped with an auditorium with operating desks as well as video projection and TV transmission technology. With renowned ophthalmic professors, Geuder conducts advanced training courses (“Perkeo” course series) and wetlabs to familiarize surgeons with the latest surgical techniques, devices and instruments.
With the MEMOTRON, Geuder is launching its first device for the anterior and posterior segments. The PHACO-ASPITRON® has been expanded to include a diathermy and cold light unit. The system is thus also suitable for use on the posterior segment of the eye. The combination of the three control units is coupled via a bus system and connected to the MEMOTRON computer unit so that, for the first time, surgeons can store different program steps in a database and then call them up and use them individually.
Together with H.-R. Koch, Geuder develops the mega ultrasound tip: its flared geometry allows phaco-surgeries to be performed with a higher vacuum and lower emission of ultrasound energy. This makes it possible for the first time to remove hard cataracts with ultrasound or to emulsify soft cataracts within a very short time. By shortening the ultrasound time, not only the efficiency can be increased, but also the risk of endothelial damage can be reduced. The "Megatip" is still Geuder's best-selling phaco tip.
Geuder introduces the Megatron® device: It is the smallest control unit for both the anterior segment (cataract) and posterior segment (vitrectomy). The Megatron® combines all the necessary functions for anterior and posterior segment procedures in one device. It can control pneumatic cutters for vitrectomy, whereas the preceding devices can only control magnetic cutters.
The unit can store settings for 4 operators and 4 modes. It is the first "digital" device from Geuder. Thus, the Megatron® replaces the preceding devices PHACO-ASPITRON®, DIATHRON and LUXATRON.
Geuder takes over Fluoron GmbH, based in Neu-Ulm (Germany). The product portfolio is thus expanded to include "ultra-pure biocompatible liquids". FLUORON®'s highly esteemed and patented products today include, for example, the thixotropic silicone oils Siluron® 2000 and Xtra, the heavy silicone oils Densiron® 68 and Xtra as well as the F4H5® WashOut solution or the non-toxic membrane dye Brilliant Peel®.
Shortly after the first toric IOL was approved by the FDA, Geuder, together with G. Gerten (Cologne, Germany), developed a pendulum marker for exact marking of the cylinder’s axis. When implanting toric IOLs, the exact correlation between the astigmatism axis and the torus of the IOL is crucial for the refractive result and patient satisfaction. The TOMARK axis marker allows direct marking of the final torus position on the seated patient to eliminate errors due to cyclorotation.
F. Price developed DSEK (Descemet's stripping with endothelial keratoplasty) and M. Gorovoy developed DSAEK one year later, in which the donor's corneal lamella is removed with an automated micro-keratome. For the gentle implantation of the sensitive lamella, Geuder developed an implantation spatula with a Teflon insert by Thomas Neuhann and an implantation instrument by Rieck, which, thanks to its oval hinges, allows the donor tissue to be rolled in in a controlled manner without overlapping. For the DS(A)EK "pull-through" technique, Geuder has also developed a delicate forceps to grip the tissue only at the outermost edge and pull it through contralaterally.
Geuder is launching the VITRON 2020 to support the WHO and IAPB initiative, which aims to eliminate preventable blindness by 2020. With nearly 90% of preventable visual impairment occurring in developing countries, this cost-effective and reliable device is designed specifically for these countries. It is intended for anterior chamber vitrectomies only, without integrated aspiration. The main buyer and distributor in emerging and developing countries is the Christoffel Blind Mission (CBM), which Geuder also supports with numerous donations of instruments.
Geuder Asia-Pacific (GAP) is founded in Singapore to supply the Southeast Asian region with quality products "made in Germany". Anil Khumar becomes the Managing Director. In the meantime, GAP can competently consult customers in India, Indonesia, Malaysia, Myanmar, Nepal, Sri Lanka, Taiwan, Thailand, Vietnam and the Philippines from 15 locations and offer a fast and reliable on-site service.
Geuder's product range has grown to over 3,000 products. Through the constant expansion of sales and export activities, the company is now selling in over 90 countries worldwide. The rapid growth of the company in recent years is also reflected in the significant increase in the number of employees to over 220.
With the megaTRON® S4, the successful Megatron® S3 is further developed with a variety of improved features for use in the anterior and posterior segment of the eye. Unlike the S3, the S4 does not require external compressed air. The new peristaltic pump with Venturi-effect brings a significant increase in the performance of the pump system. With the S4, the OCULED handpieces can be controlled and the intraocular halogen illumination of the S3 can be expanded using LED technology. The more powerful computer of the S4 enables a much smoother and faster operation of the touch screen.
With the introduction of the DMEK glass cartridge by P. Szurman (Sulzbach, Germany), Geuder supports the success of the new gentle lamellar keratoplasty technique from the very beginning and launches numerous other DMEK instruments on the market in the following years. By 2021, Geuder sells over 50,000 units, making the DMEK glass cartridge by Szurman one of the most widely used cartridges for injecting the Descemet lamella.
For effective IOL explantation through the smallest incisions, Geuder develops an IOL scissors and an IOL forceps in collaboration with M.E. Snyder and R.H. Osher (Cincinnati Eye Institute, USA). The IOL scissors by Snyder/Osher have strong and sharp scissor blades as well as grooves on the lower cutting blade to prevent the lens from sliding forward when cutting. In addition, the special handle geometry results in a large opening angle of the scissor blades. The Snyder/Osher IOL forceps offers secure holding of the lens during cutting and of the lens fragments during removal due to its specially grooved grasping surfaces.
With the introduction of the megaTRON® S4 HPS, Geuder once again improves the successful Megatron machine series. Compared to its preceding S4 device, the vitreous cutting rate is increased to 6,000 cuts per minute (equaling 12,000 cpm with the MACH2 vitrector). In addition, the S4 HPS can also control the endoTRON® 532 nm endolaser, so that the surgeon only needs one foot switch to operate a complete system. Thanks to the revised internal electronics, the boot time is reduced compared to the S4. The voice output is extended to other foreign languages and data mirroring is made possible on certain surgical microscopes.
The endoTRON® 532 nm green laser for photocoagulation completes the system of devices for the posterior segment. The endo laser can be controlled in two ways: a) integrated via the megaTRON® S4 HPS or b) stand-alone via its own Bluetooth remote control with touchscreen.
With the double-needle stabilizer and fixation ring, Geuder, in collaboration with S. Yamane (Japan), has made a significant contribution to the success of his flanged intrascleral IOL fixation technique introduced in 2016. It is a masterpiece of precision that guides 27G or 30G needles into the sclera via precise angles and insertion sites, allowing to intraoperatively align the refractive position of the IOL in 0.25D increments.
With the Homburg cross-stitch marker by S. Suffo (Homburg/Saar, Germany), it is possible to perform almost perfectly symmetrical penetrating keratoplasties (PK) without induced astigmatism. Even inexperienced surgeons can use the "7-shaped marker" to place perfect double running diagonal cross-stitch sutures by Hofmann.
The German Association for Tissue Transplantation (DGFG) receives approval of the Federal Institute for Vaccines and Biomedicines (Paul-Ehrlich-Institut, Germany) for shipping preloaded Descemet membranes to surgeons. The donor lamella can be ordered as "LaMEK Preloaded" in the Geuder DMEK RAPID® transport and ready-to-use injection system from the DGFG https://gewebenetzwerk.de/lamek-preloaded/
Geuder celebrates its 70th anniversary of the company. Since Geuder was founded in 1951 by Hans Geuder senior, many well-known ophthalmologists such as R. Osher, T. Sato, H. R. Koch, J. Barraquer, H. Sautter, M.U. Dardenne, G. Mackensen, S. Fyodorov, C. Binkhorst, T. Neuhann, W. Sekundo, D. Wong, T. Kohnen and many others have accompanied our rich history of more than 3,000 ophthalmic surgical tools. A large number of patents in over 70 countries confirm our intensive commitment to research and development as well as our forward-looking philosophy.