How a State-of-the-Art Microscope Helps to Optimize the Workflow in Cataract Surgery

Interview with Dr. Devesh Varma: “With the Proveo 8, I customize the light settings by a simple click on the foot switch.”

March 30, 2016

Typical ophthalmic procedures require specific levels of light, focus and magnification in each phase of surgery. Changing quickly between these settings is the prerequisite for an uninterrupted and smooth workflow where the surgeon can concentrate completely on his patient.

The surgical microscope for ophthalmology Proveo 8 features a unique level of customization that allows to program complete surgical phases and single parameters.

Dr. Devesh Varma is one of the first ophthalmologists having tested the Proveo 8 microscope. He is assistant Professor in the Department of Ophthalmology and Vision Sciences at the University of Toronto.

Would you please explain your field of work and describe the challenges you are dealing with?

Fig. 1: Dr. Devesh Varma, assistant Professor in the Department of Ophthalmology and Vision Sciences at the University of Toronto

Devesh Varma: I am a glaucoma and complex anterior segment surgeon. That means that in addition to a full range of glaucoma surgeries, I handle highly complicated cataracts, repair IOL complications and repair iris defects. A great part of my practice comprises teaching as well, so video recording of cases in the operating room plays a major role in my work.

What I am looking for in a surgical microscope is obviously good optics. And I especially want good optics for the videos so I can view my cases afterwards and share them.

Because I operate at fairly high magnifications, I am constantly using the foot pedal to keep tissue in optimal focus. I require the microscope to respond very quickly when I use the foot pedal – and this is what the Proveo 8 does. In my hospital I work with a Leica microscope and the reason I prefer it is the natural lighting. I prefer this to the very bright and cool light I get from other surgical microscopes.

How do you evaluate the red reflex when working with the Proveo 8?

Devesh Varma: I did notice an improvement of the red reflex when I tested the Proveo 8. What I really liked was that I could change the relative settings for the Otto flex from one step of surgery to the next by the foot switch – it is the first scope that allows me to do so. It gives me the option to choose the optimal lighting which I really appreciate when I try to capture certain things in the video. I liked that a lot and I think it is unique.

What impact does the assistant’s view have for you?

Fig. 2: The Surgeon Information Panel above the Proveo 8 optics carrier shows all current settings: light, magnification, recorder status, focus level and vitrectomy mode.

Devesh Varma: Although I can execute many surgeries without an assistant, when I do need one, it is nice for them to have as clear a view as mine.  The assistant scope really plays a role when I am training a fellow – if he or she can see what I am doing better, it enhances their learning.

If you summarize your experience with Proveo 8, what would you say?

Devesh Varma: It is really very easy to use and I particularly liked that the lighting is customizable. For me, this is an awesome feature as it allows me to optimize visualization for each surgical step and for the videos that capture them. 

For example, in angle based surgery I may want completely different lighting than I would for a capsulorhexis. By choosing the right light I can see better during surgery and when reviewing the video later. The enhanced focusing features provided a good depth of focus. It was subtle at first, but after a few cases I realized I wasn’t having to use the foot pedal to adjust focus as frequently as usual.

Fig. 3: The Proveo 8 ophthalmic microscope provides surgeons with both constant red reflex and a rich texture view, throughout entire anterior and posterior procedures.

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