The Feasibility and Clinical Evaluation of an Immersive Augmented Reality Surgical Headset Integrated with Swept-Source Intraoperative Optical Coherence Tomography for Ophthalmic Surgery in the DISCOVER Study †

Abstract

Objectives: to evaluate the feasibility and utility of intraoperative optical coherence tomography (iOCT) utilizing an immersive augmented reality surgical headset (Beyeonics iOCT, Beyeonics Vision Ltd., Haifa, Israel) digital visualization platform with swept-source integrated OCT in ophthalmic surgery. Methods: As part of the Institutional Review Board-approved prospective DISCOVER study, the Beyeonics iOCT was utilized in multiple ophthalmic surgical procedures to evaluate the feasibility and utility of iOCT with this platform. The Beyeonics iOCT is a three-dimensional surgical visualization system that utilizes a swept-source integrated OCT within the digital microscope system. Surgeon feedback on system performance and integration into the surgical workflow was gathered via a prespecified survey. Results: Thirteen eyes of thirteen patients were included in this study. The surgical procedures consisted of four cataract surgeries, two lamellar corneal transplants, one pterygium removal, and six vitreoretinal surgeries. Surgeons were able to successfully view and review the iOCT images within the surgical Head-Mounted Display, eliminating the need for an external display. Utility feedback from surgeons included iOCT assisting with confirming wound architecture, corneal graft orientation, and retinal structure. All surgeries were completed without reverting to a conventional microscope, and no intraoperative adverse events occurred. Conclusions: The new visualization platform with integrated swept-source iOCT demonstrated feasibility and potential utility in multiple ophthalmic surgical platforms. Additional research related to outcomes, ergonomics, and enhanced software analysis is needed in the future.