Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/1295122
During a recent conversa- tion, Dr. Fuller was stunned to learn that his practice was the first in Texas and only the fourth nationwide to use the heads-up technology to perform vitreoretinal surgery. While he says the system is starting to gain momentum with cataract surgeons, he finds it perfectly suited for all of his retinal cases. "It really excels when engaging in detailed, delicate macular (central retina) work," he explains. "The macula is arguably the most important and irreplaceable structure within the eye, and success — or bloody disaster — is often measured in microns." Dr. Fuller says 3D heads-up displays offer unparalleled depth of field that exceeds a surgical microscope at certain aperture settings, high- dynamic-range imaging and an array of switchable color profiles that can be activated to achieve the best possible visualization in a variety of challeng- ing clinical situations. For example, when operat- ing on a patient suffering from dense vitreous hemorrhage, the system allows him to toggle to a "red free" setting, which makes the underlying reti- na more visible. "Not only does this speed up surgical times, it enhances patients safety by making surgeons far less likely to clumsily bump against the retina in the fog of surgery," explains Dr. Fuller. The brightness of the surgical field can be superi- or to that of traditional surgery, without exposing the retina to additional light. "I commonly operate at 15% to 20% luminance with heads-up displays, whereas my colleagues who still use microscopes are commonly operating at 50% or higher," says Dr. Fuller. "Lower illumination settings make rare cases of retinal phototoxicity even far less likely." Improved ergonomics are another advantage afforded by heads-up displays. Numerous oph- thalmic surgeons struggle with repetitive strain injuries to their backs and necks that are caused by sitting in static positions at a microscope's oculars for hours on end. "My back still barks at the end of a long day in the OR, but that discomfort has less- ened since using this technology," says Dr. Fuller. He also thinks the technology's benefits far out- weigh its minor downfalls and significant price tag. "Some surgeons have griped that peripheral retinal visualization is a bit awkward, but most of those concerns melt away after three or four weeks of dedicated 3D use," says Dr. Fuller. "Also, many sur- gical facilities are not keen to dump $100,000 on a device that does not directly and immediately increase a facility's cash flow, especially in these hardscrabble times of COVID-19." Beyond reality Ochsner Medical 3D (m3D) Lab, a thinktank associ- ated with New Orleans-based Ochsner Health, applies advanced manufacturing and mixed reality to healthcare delivery. The lab creates custom 3D models to inform its patients about their unique conditions and helps them feel more comfortable about their care. "Our most mature application is in collaboration with our complex spine surgeons where 3D printed models are helping to develop and optimize surgical approaches for patients with O C T O B E R 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 4 5 EASY ON THE EYES Heads-up technology allows for a brighter surgical field without exposing the retina to additional light. Texas Retina Associates