Clinical Ophthalmology (Feb 2020)
Consolidation of Imaging Modalities Utilizing Digitally Assisted Visualization Systems: The Development of a Surgical Information Handling Cockpit
Abstract
Cassandra C Brooks,1 John Kitchens,2 Thomas W Stone,2 Christopher D Riemann3,4 1Department of Ophthalmology, Duke University, Durham, NC, USA; 2Retina Associates of Kentucky, Lexington, KY, USA; 3University of Cincinnati College of Medicine, Cincinnati, OH, USA; 4Cincinnati Eye Institute, Cincinnati, OH, USACorrespondence: Cassandra C BrooksDepartment of Ophthalmology, Duke University, 2351 Erwin Drive, Durham, NC 27705, USAEmail [email protected]: The management of vitreoretinal cases is ever-evolving, paralleled by rapid advancements in operative imaging modalities. In this article, we describe an advanced application of digitally assisted vitreoretinal surgery (DAVS) that involves the consolidation of pre-existing ancillary imaging technology into a single same-screen viewing platform. Forty-four eyes of 44 patients were operated using same screen simultaneous viewing of the primary three-dimensional high definition (3DHD) surgical field and simultaneous auxiliary video feed viewing of all currently approved ocular endoscopy (n=12), intraoperative optical coherence tomography (iOCT) units (n=24), or computer feeds from the EHR/image management software (n=8). All surgeries were successful with excellent functional and anatomic outcomes. DAVS facilitated same screen viewing of multiple video/information feeds was notable for improved ergonomics, surgical efficiency, and precision when compared to viewing the surgical field and auxiliary video feeds separately. We describe a new concept for the vitreoretinal operating room – a DAVS-based surgical information handling cockpit – integrating FDA approved ocular endoscopy (n=1), microscope-integrated iOCT units (n=3), and one EHR/Image management solution with the primary surgical field 3DHD feed. We suggest same screen viewing of multiple video and other clinical information feeds is a promising modality that may be considered in the management of patients with surgical vitreoretinal disease and should be purposefully incorporated into future iterations of DAVS technology platforms.Keywords: 3D HD machine vision, heads up surgery, digitally assisted vitreoretinal surgery, DAVS, iOCT, ocular endoscopy
