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The Future of Ophthalmic Surgery: Doctor's Experience with Zeiss ARTEVO 800 3D Microscope, Guías, Proyectos, Investigaciones de Oftalmología

An in-depth look into the benefits of using the zeiss artevo 800 3d digital microscope in ophthalmic surgery. The author, a doctor with experience in cataract, glaucoma, and retina surgery, shares his personal experience using the artevo 800 for various procedures and compares it to other digital microscope systems. The document highlights the advantages of the artevo 800, such as immersive 3d viewing, ergonomic benefits, natural colors, and real-time oct.

Qué aprenderás

  • How does the ARTEVO 800 compare to other digital microscope systems?
  • What are the benefits of using a digital microscope like the ARTEVO 800 in ophthalmic surgery?
  • What advantages does the ARTEVO 800 offer for cataract, retina, and glaucoma surgery?

Tipo: Guías, Proyectos, Investigaciones

2020/2021

Subido el 22/07/2021

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MAY/JUNE 2020 | INSERT TO RETINA TODAY
23
EDUCATIONAL CONTENT PROVIDED BY ZEISS
We are in the midst of a new era of visualization in eye
care. After years of operating under the oculars of
a microscope, we now have access to heads-up 3D
digital microscope viewing systems. As someone who
has been fortunate enough to use one of the latest
technologies, the ARTEVO 800 (Carl Zeiss Meditec AG), I can
say from experience that this is the future of ophthalmic surgery.
Here is why.
Digital microscopes offer an immersive view, on a 3D display,
with pristine image quality, magnification, and resolution.
Another benefit of using a heads-up display such as the
ARTEVO 800 is the ergonomic benefit, allowing us to sidestep
the occupational health hazards of performing microscopic
surgery, including chronic back and neck pain and other mus-
culoskeletal issues. What’s more is that a digital microscope can
be used as an imaging, information, and teaching tool in cata-
ract, retina, cornea, and glaucoma surgery. Intraoperative OCT
(RESCAN 700, Carl Zeiss Meditec AG), cataract assistance func-
tions, phacovitrectomy values, patient information, and OR set-
tings can all be overlaid onto the active surgical image without
blocking the surgeon’s view of the eye.
PERSONAL EXPERIENCE
I have used the ARTEVO 800 for cataract, glaucoma, and retina
surgery (Figure 1), the latter of which is my specific field of interest.
Within a few surgeries each, I was able to feel comfortable using this
kind of digital surgery system. I have performed traditional cataract
surgery, cataract surgery combined with vitrectomy with and without
epiretinal membrane peeling, proliferative vitreoretinopathy cases,
retinal detachments, trabeculectomy, and glaucoma stent surgeries.
A dynamic platform with capabilities in cataract and retina surgery.
BY LARS-OLOF HATTENBACH, MD, FEBO
VISUALIZATION WITH THE
ZEISS ARTEVO 800
Courtesy Foto Kunz
The views, thoughts, and opinions expressed in the article belong solely to the author.
Figure 1. Dr. Hattenbach performing a surgery in the OR with the ARTEVO 800 3D digital microscope system (A, B).
A B
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MAY/JUNE 2020 | INSERT TO RETINA TODAY 23

EDUCATIONAL CONTENT PROVIDED BY ZEISS

W

e are in the midst of a new era of visualization in eye care. After years of operating under the oculars of a microscope, we now have access to heads-up 3D digital microscope viewing systems. As someone who has been fortunate enough to use one of the latest technologies, the ARTEVO 800 (Carl Zeiss Meditec AG), I can say from experience that this is the future of ophthalmic surgery. Here is why. Digital microscopes offer an immersive view, on a 3D display, with pristine image quality, magnification, and resolution. Another benefit of using a heads-up display such as the ARTEVO 800 is the ergonomic benefit, allowing us to sidestep the occupational health hazards of performing microscopic surgery, including chronic back and neck pain and other mus- culoskeletal issues. What’s more is that a digital microscope can be used as an imaging, information, and teaching tool in cata- ract, retina, cornea, and glaucoma surgery. Intraoperative OCT (RESCAN 700, Carl Zeiss Meditec AG), cataract assistance func- tions, phacovitrectomy values, patient information, and OR set- tings can all be overlaid onto the active surgical image without blocking the surgeon’s view of the eye.

PERSONAL EXPERIENCE

I have used the ARTEVO 800 for cataract, glaucoma, and retina surgery (Figure 1), the latter of which is my specific field of interest. Within a few surgeries each, I was able to feel comfortable using this kind of digital surgery system. I have performed traditional cataract surgery, cataract surgery combined with vitrectomy with and without epiretinal membrane peeling, proliferative vitreoretinopathy cases, retinal detachments, trabeculectomy, and glaucoma stent surgeries. A dynamic platform with capabilities in cataract and retina surgery.

BY LARS-OLOF HATTENBACH, MD, FEBO

VISUALIZATION WITH THE

ZEISS ARTEVO 800

Courtesy Foto Kunz The views, thoughts, and opinions expressed in the article belong solely to the author. Figure 1. Dr. Hattenbach performing a surgery in the OR with the ARTEVO 800 3D digital microscope system (A, B).

A B

24 INSERT TO RETINA TODAY | MAY/JUNE 2020

EDUCATIONAL CONTENT PROVIDED BY ZEISS

I have also performed special cases such as the scleral fixation of a dislocated IOL with the ARTEVO 800. This kind of surgery is rather tricky because it requires suturing in the anterior segment and on the ocular surface. With other 3D surgery systems, there was always a problem with latency between the movements of your instruments and what you would see on the screen. With the ARTEVO 800, however, that is no longer a problem. I have found that this is one of the most important differences in com- parison to other digital microscope systems. The ARTEVO 800 also presents very natural colors on the screen. This is especially helpful for work on the ocular surface, when blood is visible on the conjunctiva. If you are seeing unnatu- ral colors, you are unable to, for instance, differentiate your suture and localize it on the ocular surface. This is not the case with the ARTEVO 800. The natural colors also add to my level of comfort in doing membrane peelings, and this is further enhanced by gain- ing the impression of a membrane in 3D. That’s a tremendous advantage compared with looking through conventional micro- scope oculars. Further, the ARTEVO 800 uses less light, which is less toxic for the retina. This is one of the major advantages of digital micro- scopes. When more light is required, such as when removing silicone oil and fluid air exchange, I simply hold a handheld light source just outside the eyeball.

ABUNDANT ADVANTAGES

In addition to the advantages of the ARTEVO 800 described previously, I am also impressed by its intraoperative real-time OCT, which I have found especially useful in vitreoretinal cases. For instance, in membrane-peeling procedures, it is perfect for check- ing whether all of the membrane was removed. In my workflow, I usually compare the intraoperative OCTs from before and after a membrane peel because, in some cases, it’s hard to tell whether you removed the entire membrane (Figure 2). The addition of intraop- erative OCT to the ARTEVO 800 is a complete game-changer. Also, if needed, I can switch from digital visualization on the 3D screen to visualization in the oculars and on the 3D screen in parallel. However, thus far in my early experience with the ARTEVO 800, I have not found the need to switch from 3D visualization to the conventional oculars. I think there are some cases, like in patients with very deep-lying eyes or in some trauma cases with extensive suturing on the ocular surface, that it could be helpful to have the option of switching between screen visu- alization to the oculars. Otherwise, I feel that 3D surgery can quickly become routine and, at least in my case, preferable.

CONCLUSION

The combination of digital 3D surgery and real-time OCT with the ARTEVO 800 is highly advantageous. In my mind, having the capability to use an intraoperative OCT with a high-quality 3D digital microscope will help me to execute safer surgery and thereby provide my patients with the best care possible. This feature combined with the option to switch to the con- ventional oculars definitely make the ARTEVO 800 a perfect choice for routine use. n LARS-OLOF HATTENBACH, MD, FEBO n (^) Professor of Ophthalmology, Ludwigshafen Hospital, Ludwigshafen, Germany n (^) hattenbach.lo@klilu.de n (^) Financial disclosure: Honoraria for consulting and lectures (Carl Zeiss Meditec AG) Figure 2. Internal limiting membrane peeling in a patient with macular pucker. Note the excellent magnification of the ARTEVO 800 and the use of intraoperative OCT.