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Use of a three-dimensional head-mounted digital visualization platform in cataract surgery

Eye volume 37, pages 2905–2908 (2023)Cite this article

Subjects

Abstract

Objective

To report preliminary experience using the BeyeonicsOne (Beyeonics Vision, Haifa, Israel) digital visualization platform and the utilization of its three-dimensional (3D) head-mounted display (HMD) in cataract surgery.

Methods

An interventional case series including patients who underwent cataract surgery using the 3D HMD platform at the Tel Aviv Medical Center. The system uses the HMD unit to display high-resolution real-time 3D surgical field images. Collected data included patient demographics, ocular comorbidities, risk factors for complex cataract surgery, cataract grading, preoperative and postoperative best-corrected visual acuity (BCVA), and intra- and postoperative complications.

Results

In total, 60 eyes of 60 subjects (mean age 73.1 ± 8.4 years) were included. Mean preoperative BCVA was 0.40 ± 0.30 logMAR (Snellen equivalent ~20/50) and improved to 0.10 ± 0.10 logMAR (Snellen equivalent ~20/25, p < 0.001). None of the patients suffered BCVA loss. All procedures and follow-ups were uneventful except for one case of a posterior capsular tear and one case of post-surgical cystoid macular edema.

Conclusion

The visualization platform and its embedded 3D head-mounted display can be easily used in routine cataract surgery with the added benefits of improved ergonomics, high picture quality and enhanced image control.

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Fig. 1: System Components.
Fig. 2: Ergonomic Consideration.

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Data availability

All data generated or analyzed during this study are included in this published article.

References

  1. Keeler R. The evolution of the ophthalmic surgical microscope. Hist Ophthalmol Int. 2015;1:35–66.

    Google Scholar 

  2. Eckardt C, Paulo EB. Heads-up surgery for vitreoretinal procedures: an experimental and clinical study. Retina. 2016;36:137–47.

    Article  PubMed  Google Scholar 

  3. Montes De Oca I, Kim EJ, Wang L, Weikert MP, Khandelwal SS, Al-Mohtaseb Z, et al. Accuracy of toric intraocular lens axis alignment using a 3-dimensional computer-guided visualization system. J Cataract Refract Surg. 2016;42:550–5.

    Article  PubMed  Google Scholar 

  4. Palácios RM, de Carvalho ACM, Maia M, Caiado RR, Camilo DAG, Farah ME. An experimental and clinical study on the initial experiences of Brazilian vitreoretinal surgeons with heads-up surgery. Graefes Arch Clin Exp Ophthalmol 2019;257:473–83.

    Article  PubMed  Google Scholar 

  5. Palácios RM, Kayat KV, Morel C, Conrath J, Matonti F, Morin B, et al. Clinical study on the initial experiences of French vitreoretinal surgeons with heads-up surgery. Curr Eye Res. 2020;45:1265–72.

    Article  PubMed  Google Scholar 

  6. Weinstock RJ, Ainslie-Garcia MH, Ferko NC, Qadeer RA, Morris LP, Cheng H, et al. Comparative assessment of ergonomic experience with heads-up display and conventional surgical microscope in the operating room. Clin Ophthalmol. 2021;15:347–56.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Helayel HB, Al-Mazidi S, Alakeely A. Can the three-dimensional heads-up display improve ergonomics, surgical performance, and ophthalmology training compared to conventional microscopy? Clin Ophthalmol. 2021;15:679.

    Article  Google Scholar 

  8. Charles S. Illumination and phototoxicity issues in vitreoretinal surgery. Retina. 2008;28:1–4.

    Article  PubMed  Google Scholar 

  9. Nariai Y, Horiguchi M, Mizuguchi T, Sakurai R, Tanikawa A. Comparison of microscopic illumination between a three-dimensional heads-up system and eyepiece in cataract surgery. Eur J Ophthalmol. 2021;31:1817–21.

    Article  PubMed  Google Scholar 

  10. Adam MK, Thornton S, Regillo CD, Park C, Ho AC, Hsu J. Minimal endoillumination levels and display luminous emittance during three-dimensional heads-up vitreoretinal surgery. Retina. 2017;37:1746–9.

    Article  PubMed  Google Scholar 

  11. Panthier C, Courtin R, Moran S, Gatinel D. Heads-up descemet membrane endothelial keratoplasty surgery: feasibility, surgical duration, complication rates, and comparison with a conventional microscope. Cornea. 2021;40:415–9.

    Article  PubMed  Google Scholar 

  12. Gomel N, Levinger E, Lankry P, Cohen S, Schwartz S, Barak A, et al. Use of a novel three-dimensional head-mounted digital visualization platform in corneal endothelial transplantation. Ophthalmol Ther. 2023;12:625–31.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Nir Sorkin, Eliya Levinger, Asaf Achiron, Nir Gomel, Shai Cohen, Gilad Rabina, Shulamit Schwartz, Adiel Barak, Anat Loewenstein & David Varssano

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  1. Nir Sorkin
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  2. Eliya Levinger
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Contributions

NS was responsible for designing the work, acquiring and analyzing data, drafting the manuscript and revising the manuscript. EL was responsible for designing the work, acquiring data, and revising the manuscript. AA was responsible for acquiring data, analyzing data, and revising the manuscript. NG was responsible for acquiring data and revising the manuscript. SC was responsible for acquiring data and revising the manuscript. GR was responsible for interpreting data and revising the manuscript. SS was responsible for acquiring data and revising the manuscript. AB was responsible for designing the work, acquiring data, and revising the manuscript. AL was responsible for designing the work, interpreting data, and revising the manuscript. DV was responsible for designing the work, interpreting data, and revising the manuscript.

Corresponding author

Correspondence to Nir Sorkin.

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Competing interests

AB, NS and AL are consultants for Beyeonics Vision. NS received advisory board honoraria from Beyeonics Vision.

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Sorkin, N., Levinger, E., Achiron, A. et al. Use of a three-dimensional head-mounted digital visualization platform in cataract surgery. Eye 37, 2905–2908 (2023). https://doi.org/10.1038/s41433-023-02427-w

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