Advanced video overlay system offers multiple benefits

Key Points

Chicago-A new video overlay system (Surgical Media Center [SMC], Advanced Medical Optics [AMO]) on a proprietary phacoemulsification platform (WhiteStar Signature, AMO) represents a valuable tool for enabling anterior segment surgeons to optimize their machine settings and refine their surgical techniques, said Ann Haustermans, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

Dr. Haustermans, Department of Ophthalmology, Az Klina Hospital, Brasschaat, Belgium, described the features of the specialized media software and demonstrated its operation and capabilities. She said the video overlay system also can be connected via supplied cables to other propietary phacoemulsification systems (Sovereign and Sovereign Compact Systems, AMO).

The video overlay system is a video capture system that performs continuous taping of cataract surgery procedures and blends real-time operating data from the phaco system with the video image from the surgical microscope. It consists of a video control module plus a Windows-based laptop computer that has enhanced-resolution display and pre-installed software.

"In particular, the video control module represents a simple user interface for manual control of starting, ending, and playing back the recording," Dr. Haustermans said.

Videos are recorded in MPEG-2 format, and the system has a high-video database storage capacity to allow at least 25 hours of recording time. Using the laptop computer, surgeons can review the surgical video in a variety of customizable formats and in a frame-by-frame technique so that they can focus on specific surgical parameters and data.

"With its high-storage capacity, DVD quality recordings, and comprehensive playback and editing capacity, the [video overlay system] provides an easy way for surgeons to collect documentation for quality assurance and to facilitate review of surgical data and events," Dr. Haustermans said. "It also represents a unique method for detailed review of surgery so that surgeons can refine their own techniques or use it as a teaching tool for surgeons in training. Moreover, the [video overlay system] can be used to produce advanced, high-definition presentations."

The overlay graphics on the system are kept separate from the video in a companion file rather than embedded in it. Therefore, surgeons have greater flexibility in customizing the playback recording as they can change the overlay before or after it is captured.

"When surgeons play back the recording, they can bring the overlay data in and out as they wish, or they can customize the overlay display in a variety of ways," she said. "Information such as surgeon name, program name, bottle height, and foot pedal position, among other items, can be selected to appear in the overlay, and logos, pictures, and comments can also be added. Once a preferred layout is created, the surgeon can name it and save it."

As part of its capabilities, the video overlay provides a graphical representation of phaco instrument activity, and the data for aspiration, vacuum, and ultrasound power can be selected to appear in a variety of formats, including data plots, bar graphs, or speedometers. Dr. Haustermans said the data plots represent the most interesting overlay.

"This data display presents a simultaneous, color-coded, real-time tracking of changes in aspiration, vacuum, and ultrasound power during the entire procedure and, therefore, allows surgeons to appreciate interactions between these parameters and the performance of the phaco system," she said.

As an example Dr. Haustermans called attention to how changes in the data plot of vacuum levels provide an illustration of the way the fluidics (Fusion Fluidics, AMO) on the phaco platform anticipates vacuum breaks to prevent surge.

"When the [fluidics] system recognizes occlusion, the pump direction is automatically reversed," she said. "The graphical display shows how vacuum steps down quickly once the vacuum level crosses the 'up threshold' to prevent surge and maintain chamber stability."