Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;12(1):625-631.
doi: 10.1007/s40123-022-00624-6. Epub 2022 Dec 12.

Use of a Novel Three-dimensional Head-mounted Digital Visualization Platform in Corneal Endothelial Transplantation

Nir Gomel  1 , Eliya Levinger  2 , Polina Lankry  2 , Shai Cohen  2 , Shulamit Schwartz  2 , Adiel Barak  2 , Anat Loewenstein  2 , David Varssano  2 , Nir Sorkin  2
Affiliations

Use of a Novel Three-dimensional Head-mounted Digital Visualization Platform in Corneal Endothelial Transplantation

Nir Gomel et al. Ophthalmol Ther. 2023 Feb.

Abstract

Introduction: To report the first endothelial keratoplasty procedures performed using a 3D digital head-mounted ophthalmic exoscope.

Methods: Three patients underwent Descemet stripping automated endothelial keratoplasty (DSAEK) using a 3D digital ophthalmic exoscope (Beyeonics One, Beyeonics Vision, Haifa, Israel) at the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Results: All procedures were uneventful, leading to resolution of corneal edema and vision improvement. Surgeons reported excellent visualization and minimal lag, almost negligible, with the benefits of improved ergonomics and the use of head gestures to control zoom, focus, brightness, and panning. There were no postoperative complications.

Conclusion: The new 3D digital ophthalmic exoscope system can be successfully used in DSAEK surgery with potential advantages in ergonomics, picture quality, and image control. Further studies can compare this system with either standard operating microscopes or 3D heads-up display systems.

Keywords: Corneal endothelial transplantation; Descemet stripping automated endothelial keratoplasty (DSAEK); Exoscope; Head gesture; Head-mounted display (HMD); Heads-up; Microscope; Surgery; Three-dimensional (3D); Visualization.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Side view (a) and front view (b) of the three-dimensional head-mounted display, and the head-mounted display being used in DSAEK surgery (c)
Fig. 2
Fig. 2
Surgeon-view image during the final stages of a DSAEK procedure
Fig. 3
Fig. 3
The main system suite, including the camera unit, the workstation unit and a semi-robotic arm carrying the camera unit
See this image and copyright information in PMC

References

    1. Keeler R. The evolution of the ophthalmic surgical microscope. Hist Ophthal Intern. 2015;1:35–66.
    1. Eckardt C, Paulo EB. Heads-up surgery for vitreoretinal procedures: an experimental and clinical study. Retina. 2016;36(1):137–147. doi: 10.1097/IAE.0000000000000689. - DOI - PubMed
    1. Montes De Oca I, Kim EJ, Wang L, et al. Accuracy of toric intraocular lens axis alignment using a 3-dimensional computer-guided visualization system. J Cataract Refract Surg. 2016;42(4):550–555. doi: 10.1016/J.JCRS.2015.12.052. - DOI - PubMed
    1. Palácios RM, de Carvalho ACM, Maia M, Caiado RR, Camilo DAG, Farah ME. An experimental and clinical study on the initial experiences of Brazilian vitreoretinal surgeons with heads-up surgery. Graefes Arch Clin Exp Ophthalmol. 2019;257(3):473–483. doi: 10.1007/S00417-019-04246-W. - DOI - PubMed
    1. Adam MK, Thornton S, Regillo CD, Park C, Ho AC, Hsu J. Minimal endoillumination levels and display luminous emittance during three-dimensional heads-up vitreoretinal surgery. Retina. 2017;37(9):1746–1749. doi: 10.1097/IAE.0000000000001420. - DOI - PubMed

LinkOut - more resources