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. 2025 Jul;14(7):1597-1609.
doi: 10.1007/s40123-025-01117-y. Epub 2025 Apr 11.

New Mixed Reality Headset: First Exploratory Use in Intraocular Surgery and Telementoring

Rodolfo Mastropasqua  1 , Maria Ludovica Ruggeri  2 , Alberto Quarta  3 , Ruggero Tartaro  4 , Luca Vecchiarino  4 , Luca Virgilio Corboli  3 , Lorenza Brescia  4 , Matteo Orione  5 , Andrea Russo  5 , Teresio Avitabile  5 , Leonardo Mastropasqua  3
Affiliations

New Mixed Reality Headset: First Exploratory Use in Intraocular Surgery and Telementoring

Rodolfo Mastropasqua et al. Ophthalmol Ther. 2025 Jul.

Abstract

Introduction: In this work, we aimed to explore the applicability of a mixed reality headset (MRH) in intraocular surgery and its potential benefits as an innovative telementoring model of surgical teaching.

Methods: A total of nine surgeries were performed. All surgeries were planned and performed with the aid of the Apple Vision Pro (Apple Inc., Cupertino, CA, USA) MRH integrated with multimodal imaging technology to provide a dynamic, detailed, real-time, all-in-one three-dimensional (3D) live visualization of surgical cases. A live connection between surgeons enabled real-time sharing of the surgical field. Feedback from surgeons and fellows, along with their satisfaction levels, was recorded to assess the applicability of this approach in intraocular surgery and surgical education.

Results: The integrated system proved to be an efficient all-in-one solution, demonstrating efficacy in surgical planning and keeping the surgeon informed throughout the procedure (> 8). No signal delay nor additional complications were detected in the real-time video feed, which allowed for uninterrupted guidance throughout the procedure. Both surgeons and fellows showed overall satisfaction and interest in the new model (> 8), appreciating the advantages in terms of knowledge gap filling, future perspective in surgical telementoring, and the possibility of application in surgical training.

Conclusions: Introducing an MRH in intraocular surgery provides an innovative and immersive visualization, leading to significant benefits in telementoring. This advancement opens new educational opportunities and could be a game-changer in the training of future ophthalmic surgeons.

Keywords: Apple Vision Pro; Artificial intelligence; Augmented reality; Intraocular surgery; Mixed reality; Telementoring; Virtual reality; Zeiss ARTEVO.

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Conflict of interest statement

Declarations. Conflict of interest: Rodolfo Mastropasqua, Maria Ludovica Ruggeri, Alberto Quarta, Ruggero Tartaro, Luca Vecchiarino, Luca Virgilio Corboli, Lorenza Brescia, Matteo Orione, Andrea Russo, Teresio Avitabile and Leonardo Mastropasqua have nothing to disclose. Ethical Approval: The study adhered to the principles outlined in the Declaration of Helsinki, and all patients provided written informed consent (Code AR2024). The authors confirm they have permission from those who appear in the videos to publish them.

Figures

Fig. 1
Fig. 1
The all-in-one interface showing the surgical scenario in which the device was used. The interface offers the surgeon the possibility of navigating among the different imaging modalities. Moreover, the FaceTime functionality allows direct tutor–learner contact during surgery
See this image and copyright information in PMC

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