Imaging system takes OR microscope to next level

As imaging continues to move in the direction of digital technology, one such vision platform (3-D HD, TrueVision) takes a stereoscopic view of a surgical microscope, converts it to a three-dimensional, high-definition digital image, and displays it on a projection screen. The technology, according to surgeons who have used it, affords a defined depth of field, offers the ability to play back and share images, and results in less neck and back strain.

Key Points

• Depth of field. A 3-D image helps to define depth-of-field when making incisions.

"The depth at which you sculpt is very important, and you can't see that in a two-dimensional (2-D) image," Fleming said. "You can see how deep [incisions] are and the rate that they are going."

Eric D. Donnenfeld, MD, clinical professor of ophthalmology, New York University, and a founding partner of Ophthalmic Consultants of Long Island, Rockville Centre, NY, agreed. "It's much easier to judge how far away the posterior capsule is [with 3-D imagery]," he said.

• Ability to play back and share images. Images can be played back in high-definition 3-D for students or the patient's family members to demonstrate particulars of the surgery. The images also enable the entire OR to participate in the surgery, prepare to assist, or learn from the procedure.

Often, 2-D images are inadequate, Fleming said. "Try to tear a capsule in a 2-D image. You'd never be able to do it," he said.

"It's a wonderful teaching tool because [the system shows] images in 3-D, and everyone in the room gets that full appreciation," Dr. Donnenfeld said. "[Many] teaching surgeons are switching to this technology because it provides quality visualization."

• Less (or no) neck and back strain. Because the image is projected on a screen, the surgeon no longer needs to look down and in a microscope as he or she works.

"For someone who does a lot of surgery, it's a lot easier on the neck and back," Dr. Donnenfeld said. "It's an occupational hazard for ophthalmic surgeons to have neck and back problems. The number of ophthalmologists who have had neck surgery is significant.