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SPOTLIGHT ON TECHNOLOGY & TECHNIQUE

The 3D digital ophthalmic microscope is here

Zeiss ARTEVO 800 gives everyone in the OR an impressive view — and saves your back.

Ophthalmic surgery can be painful … for the physician. As many as 50% of ophthalmologists encounter common musculoskeletal disorders, including back, neck and shoulder pain as well as numbness in their arms and legs, according to a paper by Santosh Honavar, MD, published in 2017 in the Indian Journal of Ophthalmology. These issues can lead to reduced productivity, early retirement and even disability.

The Zeiss ARTEVO 800 3D digital ophthalmic microscope introduces a new era in ophthalmic visualization and surgical comfort.

DIGITAL INTEGRATION

The ARTEVO 800 is a 3D digital ophthalmic microscope with two 3-chip 4K cameras, according to Carl Zeiss Meditec. Rather than trying to put a modular digital camera head on top of a conventional microscope, the optics of the digital system are integrated right into the microscope, according to Zeiss. This reduces the issues of lag and delay.

A hybrid mode is available if the surgeon wants the option of using oculars, but Brandon Ayres, MD, of Ophthalmic Partners of Pennsylvania, Cornea Service, Wills Eye Institute, has found little need to switch.

“Oculars are our security blanket and stepping away from them can be daunting at first, but with the visualization offered by the ARTEVO 800, they are no longer necessary,” he says. Dr. Ayres presented the ARTEVO 800 at the ASCRS meeting in May 2019.

RESOLUTION

The 4K resolution is four times the pixel resolution or twice the line resolution of 1080p, with each camera delivering 3840 × 2160 pixels, while using one chip for each of the colors (red, blue and green). The images are displayed on a 4K medical-grade monitor capable of displaying 3D images. This eliminates the potential for significant refresh and delay issues, according to Dr. Ayres.

DEPTH OF FIELD, FOCUS

Other valuable features, as stated by Dr. Ayres, are the microscope’s depth of field and depth of focus. When performing cataract surgery, the surgical field remains clear and sharp. The surgeon has minimal need to step on the foot pedal to adjust the focus, which accelerates workflow.

“If you are performing a phacovitrectomy, you’ll need to adjust the focus between putting in the sclerotomies and removing the vitreous. But, when performing anterior segment surgery, you can pretty much just find the focus and set the zoom,” Dr. Ayres says.

Also, the AutoAdjust feature ensures that visualization is optimized for the surgical situation, whether the operation takes place in digital or hybrid mode, or in the anterior or the posterior chamber, which the company says speeds workflow by streamlining the OR.

The ARTEVO 800’s two 3-chip 4K cameras deliver clear images in natural colors.

OPTICS

The DigitalOptics (patent pending) allow for operating with reduced light intensity, preventing issues of phototoxicity. According to Zeiss, the ARTEVO 800 offers xenon, LED or halogen light source options. “This allows the surgeon to modify the light source, mimicking what is most familiar while keeping a real color impression for increased certainty,” says Dr. Ayres. The light is patented stereo-coaxial illumination.

REAL-TIME OVERLAY

“One of the most exciting and useful features of the ARTEVO 800 is AdVision, the ability to overlay data such as preoperative biometry, surgical tracking and intraoperative OCT in real time, for critical decision-making during surgery without blocking the surgical field,” says Dr. Ayres.

Cloud connectivity allows for integration with other devices that use DICOM standard patient data, including the Zeiss Cataract Suite and Zeiss Visalis 500.

ERGONOMICS AND TEAMWORK

With the ARTEVO 800, surgeons enjoy an ergonomic, comfortable experience — ie, no more hunching. The surgeon and team require 3D polarized glasses for precision stereopsis, but according to Dr. Ayres, they are so comfortable you forget that you are wearing them.

The visualization offered by the ARTEVO 800 “gets the entire team involved and is excellent for teaching, because everyone has the surgeon’s view,” Dr. Ayres explains. “It has been particularly useful for my operating room staff and anaesthesiologist, because they are able to gain a better perspective. The only time this may be disconcerting is when the surgical assistant, who might be tying a suture, for example, is utilizing the surgeon’s view rather than his or her own.”

Dr. Ayres adds that the transition time required to be able to use the display of the ARTEVO 800 is almost nonexistent.

The ARTEVO 800’s 3D digital image quality allows for enriched visualization and data integration, Dr. Ayres says. Coupled with an efficient workflow and excellent ergonomics, the ARTEVO 800 can boost your career — and pre-empt backaches. OM

Dr. Ayres is a consultant and speaker for Zeiss but has no financial interest in the company.