Focusing on a better view

Surgeries performed so far include vitrectomy, endolaser treatment, removal of lens fragments after cataract surgery, membrane peeling, ILM peel, retina detachment, and cataract. (Image courtesy of Beyeonics)

A new transparent, head-wearable display modeled after air fighter pilot technology aims to make ophthalmic surgery more precise.

Reviewed by Anat Loewenstein, MD

A new head-mounted camera display customized for ophthalmic surgery could help eye surgeons with surgical resolution and precision, said Anat Loewenstein, MD, Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel.

The head-mounted display-also called a transparent, head-wearable display-and three-dimensional (3-D), ultra-resolution camera with a remote digital arm have several features, including 10× HD resolution, natural 3-D vision, and intuitive head gesture control that is essentially an extension of the body.

“There is the potential for unlimited virtual information that is personalized and overlaid,” Dr. Loewenstein said. Dr. Loewenstein shared information about the Clarity surgeon-centered visualization and information platform, designed by the company Beyeonics.

The company is a spinoff of Elbit, which developed a pilot head mount display used by air fighter craft pilots to display flight data, videos, and symbolics critical for flight, Dr. Loewenstein explained.

She described how the system has personalized screens that can have various inputs, sizes, and positions. One example she gave was optical coherence tomography imaging that could be potentially overlaid onto the surgeon’s view.

“Basically, it can be personalized to the person’s needs and preferences,” she said. Users of the system can move their head to change the focus of the camera, and control image enhancement and lighting.

“Using head gestures, the surgeon can shift between different virtual screens, and control functions such as focus and transparency transitions,” according to the Beyeonics website.

Other potential surgical applications described by Dr. Loewenstein included fluorescein imaging to aid with preplanning and reduced illumination that could help when treating epiretinal membrane, so there is less light toxicity.

At her center, she and fellow surgeons used the Beyeonics system for 25 cases. An additional 15 cases have been performed by Pravin Dugel, MD, Retina Consultants of Arizona, Phoenix.

Surgeries performed so far include vitrectomy, endolaser treatment, removal of lens fragments after cataract surgery, membrane peeling, internal limiting membrane (ILM) peel, retina detachment, and cataract.

Dr. Loewenstein described the transparent head-wearable display worn during surgery as lightweight. She also never experienced any imaging lag time during the surgeries she performed.

Other advantages of the system include good visualization and clarity, good field of view, and the ability to not be attached to the surgical microscope, according to Dr. Loewenstein. Although

Dr. Loewenstein was not aware of the cost of the technology, she said it may rival the price of a surgical microscope. When asked about the system’s learning curve, Dr. Loewenstein said she believes it is an easy system to learn, once the basics are established.

Disclosures:

Anat Loewenstein, MD
E: anatl@tlvmc.gov.il
This article was adapted from Dr. Loewenstein’s presentation at the 2018 meeting of the American Academy of Ophthalmology. Dr. Loewenstein is a consultant for Beyeonics.