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difference both at home and in the OR. "In my house, we have 2 75- inch TVs," says Dr. Schaal, the chair of the Department of Ophthalmology & Visual Sciences at the University of Massachusetts Medical School. One, she says, is a state-of-the-art 4K model; the other is just an old-fashioned high-def set. Any difference? "There's a big difference," she says. "The 4K tech- nology is really amazing." That's true in the operating room, too, where improved clarity prom- ises unprecedented precision. For starters, when you magnify a 4K image (which has 4 times as many pixels as high-def), you lose little or nothing in the way of resolution. That's a great feature, she says, when you're dealing with membranes that are measured in microns, and that make a strand of hair seem thick by comparison. "The image is much brighter and much easier to understand," she says. But the real benefit of 4K comes when you combine it with heads-up 3D projection, says Dr. Schaal. Retinal surgery has traditionally been done under a microscope, where the image is flat and has only moder- ately good resolution. The only way to teach was to have someone sit- ting next to you looking through a side view of the scope and seeing the same uninspiring view. "The higher resolution you get with 4K is better," says Dr. Schaal, "but the 3D is actually more revolutionary, because everyone in the room can appreciate the 3-dimensional complexity of the retina." Rishi Singh, MD, a staff surgeon at Cleveland Clinic's Cole Eye Institute and an associate professor of ophthalmology at Case Western University, says the first time he did a 4K + 3D case, one of his nurses turned to him and said, "Wow, I can't believe that's what you've been doing all this time." When everyone in the room can see what's going on, everyone is that much more engaged, says Dr. Singh. "They can anticipate needs and 1 1 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 7