OPHTHALMOLOGY/IMAGE-GUIDED SURGERY: 'Heads-up' 3D-enabled retinal surgery broadcast live

A surgical microscope with integrated heads-up 3D display was used for the first time to facilitate ophthalmic surgery at the Klinikum Frankfurt Höchst; performed by Prof. Dr. med. Claus Eckardt, the procedure was broadcast live to an audience of 1200 surgeons at the Frankfurt Retina Meeting (Mainz, Germany) on March 15, 2014.

The visualization platform consisted of a Leica Microsystems (Wetzlar, Germany) M822 ophthalmic microscope with integrated TrueVision 3D (Santa Barbara, CA) technology. The microscope, which enables insertion of tiny light probes into the eye for cataract and retinal surgery, is less invasive than standard technology. It allows observation of the operating field on a monitor rather than through eyepieces, and gives the entire operating team the same field of view as the surgeon. Digital amplification of the camera signal provides visualization of intraocular structures with low-intensity light, lowering the risk of light-induced retinal damage.

Leica's modular microscopes and proprietary OpenArchitecture allow integration into digital imaging and data systems; TrueVision 3D technology can also be adapted to future surgical guidance applications.

The two companies, whose alliance last year resulted in the first surgical microscope integrated with TrueVision's 3D intelligent visualization technology for neurosurgery, now fuses 3D technology into Leica Microsystems' entire line of ophthalmic microscopes. The expanded relationship, combining optical and digital microscopy into a single platform, is designed to drive precise patient outcomes, enhance surgeon ergonomics, and facilitate surgical staff communication, along with medical education benefits. "This integration creates a seamless, upgradeable platform that will help surgeons gain a more realistic perception of anatomical structures as a result of the depth perceived in 3D," said Dr. Heinrich Dreyer, vice president of Leica Microsystems' Medical Division.

Eckardt said, "I now routinely use 'heads up' 3D surgery in all retinal and cataract cases, and believe many surgeons will perform ophthalmic surgery this way within 5 years." He added that the implication for digital imaging, beyond the obvious ergonomic benefit, is to improve visual outcomes for many ophthalmic surgical procedures, including cataract, cornea, glaucoma, and retina.