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3D ophthalmic surgery

Positive surgical experience with digital ophthalmic microscope

Dermot McGrath

Posted: Monday, November 2, 2020


Screen is kept in a position for the surgeon to visualise
with ease and operate
Courtesy of Natarajan. S. MD, FRCS

Using a 3D-capable digital ophthalmic microscope (Artevo 800, Carl Zeiss Meditec) offers a number of advantages for ocular surgery including improved visualization, flexibility, comfort and workflow benefits, according to Natarajan. S., MD, FRCS (Glasgow), DSc, FICO, FELAS, FAICO (Retina Vitreous).

“There was no steep learning curve in adapting to this new device in the OR. It was very comfortable to use with no strain on the eyes and with a very relaxed head and neck posture for the surgeon. To avoid back problems, I advise ophthalmic surgeons to do regular exercise for back and neck. It gives excellent views of the various tissue layers and renders high-resolution images with natural colours,” Dr Natarajan said at the World Ophthalmology Congress 2020 Virtual.

Explaining the principal features of the Artevo 800 system, Dr Natarajan, Aditya Jyot Eye Hospital, Mumbai, India, said that it produces a stereoscopic 3D image that is viewed using passive polarised glasses on a 55-inch 4K monitor. The monitor can be positioned anywhere in the operating room, providing the surgeon with a comfortable position and the rest of the operating team with a clear view of the ocular anatomy.

The device transmits 25% percent more light than conventional optics so surgery can be performed at a reduced light intensity, exposing least light to retina.

“It delivers very crisp resolution with improved visualisation of the surgical field. The depth of focus enables a smooth transition to different stages of the surgery without the need to refocus the microscope. It’s all automatic and the lag in transmission is much less than what we used to experience with previous 3D systems. The contrast and colour of tissue are unaltered from the real image which is very useful benefit during surgery,” he said. The experience of using ARTEVO 800 is watching all the retinal structures in a big screen, which enhances depth perception and helps to differentiate various planes like ILM, ERM, etc.

The ARTEVO 800 incorporates a hybrid mode in which the surgeon can use the oculars while the OR staff can continue to use the 3D screen, so that the operating room layout need not be altered for every surgeon, said Dr Natarajan.

“The ARTEVO offers a lot of advantages. For cataract surgery, the depth of the trench is notable and posterior capsule tension and wrinkling can be seen very well. For vitreoretinal surgery, the best view is obtained by combining with chandelier illumination. There is clear distinction of membranes when dissecting and better visualisation of stained vitreous,” he said.

The digital microscope can also overlay data such as preoperative biometry, phaco vitrectomy values, patient information, surgical tracking and intraoperative OCT in real time without blocking the surgical field.

Dr Natarajan added that the combined features of the ARTEVO 800 make it very useful for teaching residents and fellows in the OR room.

Natarajan. S: prof.drsn@gmail.com