AIM: To evaluate the utility of a 3D digital visualization system during complex ophthalmic surgery in a private hospital setting in Australia.

METHODS: The SeeLuma system was introduced to the Eye Clinic at the Mater Private Hospital Redlands, Australia, which serves a large regional population and provides a full-time ophthalmic theater. Observational data were collected on procedures using the system, assessing visualization quality, surgeon posture, workflow efficiency, and teaching opportunities.

RESULTS: The 3D visualization system provided excellent depth of focus and peripheral visualization, without the need for intraoperative refocusing. Complex surgeries that benefited from the system included cases with small pupils, zonular weaknesses, and sutured lenses, during procedures such as minimally invasive glaucoma surgery, red-free cataract surgery, Preserflo glaucoma microshunt implantation, manual small-incision cataract surgery, and traumatic cataract surgery. Surgeons reported a neutral head and neck position when using the C-shape arm, minimizing musculoskeletal strain, which is a common complaint for ophthalmologists. Staff noted intuitive setup, and that the large monitor facilitated an optimal viewpoint for the whole multidisciplinary operating team without crowding. Teaching was enhanced through high-quality annotation and recording, and further exploration of 3D recording is planned.

CONCLUSION: Implementation of a 3D visualization system in a private hospital setting was associated with excellent visualization during complex surgery. Benefits in ergonomics, workflow, and teaching were also noted. These findings suggest that 3D digital visualization systems may be beneficial for ophthalmic surgical teams performing complex surgeries in similar clinical environments.

SUPRACOR is Bausch and Lomb’s proprietary presbyopic laser algorithm, licensed for use with the Teneo Model 2 excimer laser. SUPRACOR produces a central corneal zone of variable curvature, resulting in an extended depth of focus. This was a prospective, single-blind, single-centre study conducted at OasisEye Specialists in Kuching, Malaysia. Twenty-six presbyopic patients with myopia received TransPRK in both eyes. To achieve a mini-monovision effect, the dominant eye received PROSCAN aspheric ablation targeting plano, whereas the non-dominant eye received SUPRACOR STRONG targeting -0.75. Primary outcome measures included binocular uncorrected distance, intermediate and near visual acuity. Secondary outcome measures included distance and near stereopsis, spectacle independence and patient satisfaction.

At baseline, mean±standard deviation (SD) age was 43.6±5.3 years. Mean±SD refractive error (S/C) was 3.79±2.52/-0.89±0.58. At an average of 6 months postoperatively, patients had mean binocular UDVA, UIVA (60cm), and UNVA (40cm) of 0.01±0.08, 0.01±0.12, and 0.06±0.16 logMAR, respectively. While 19% (n=5), 42% (n=11), and 39% (n=10) of patients achieved distance (3m) stereo outcomes of 60arcsec, 120arcsec, and ≥180arcsec, 70% of patients (n=18) achieved near (40cm) stereo outcomes of ≤63arcsec. There was no subjective loss of stereopsis. 90% of respondents were completely spectacle independent for driving and intermediate tasks, with 80% reporting complete independence for small print. 80% reported ‘complete’ satisfaction with SUPRACOR.

TransPRK with SUPRACOR results in high spectacle independence and satisfaction, with no subjective loss of stereopsis.

This prospective, randomized, single-surgeon study evaluated the long-term safety, efficacy, and refractive stability of transepithelial photorefractive keratectomy (tPRK) compared with conventional photorefractive keratectomy (PRK), with follow-up to 36 months. Thirty-five patients undergoing refractive correction for ametropia received tPRK in one eye and conventional PRK in the contralateral eye. Outcomes assessed included manifest refraction spherical equivalent (MRSE), monocular uncorrected and corrected distance visual acuity (UDVA and CDVA), refractive predictability, adverse events, and patient-reported visual outcomes.

At 36 months, both groups demonstrated sustained visual and refractive stability. Mean (SD) photopic UDVA was −0.02 (± 0.09) logMAR for tPRK and 0.03 (± 0.14) logMAR for PRK, while mean photopic CDVA was −0.06 (± 0.06) logMAR and −0.05 (± 0.06) logMAR, respectively. Under mesopic conditions, mean UDVA was 0.01 (± 0.12) logMAR for tPRK and 0.03 (± 0.15) logMAR for PRK, and mean CDVA was −0.03 (± 0.10) logMAR and −0.05 (± 0.05) logMAR, respectively. Mean MRSE was 0.03D (±0.37) and –0.14D (±0.39) at 6 months for tPRK and PRK, respectively – and remained close to plano out to 36 months (−0.24D [± 0.31] and −0.31D [± 0.38], respectively). No eyes experienced clinically significant CDVA loss, intraocular pressure remained within normal limits, and no visually significant corneal haze was observed. Contrast sensitivity remained stable and comparable under photopic and mesopic conditions.

Overall, tPRK demonstrated visual and refractive outcomes equivalent to conventional PRK through 36 months, supporting its long-term effectiveness as a surface ablation technique with procedural advantages in terms of speed and efficiency.