Phacoemulsification With Real-Time Remote Collaboration

Ernesto Calvo, MD; Salomon Abouganem, MD; and Eric Rosenberg, DO

Eyetube

Ernesto Calvo, MD, performs routine phacoemulsification using an Apple Vision Pro for intraoperative visualization, taking its feed from the Ngenuity 3D Visualization System (Alcon). The video opens with the surgeon positioning and sizing the operative image within the virtual field before the case begins. This setup takes approximately 5 minutes. Because the view is not confined to the microscope optics, the surgeon's hands remain visible alongside the surgical field, making it possible to watch instrument handling and the transitions between steps. During the case, Eric Rosenberg, DO, joined live from New York, annotating directly on the shared view, with a third surgeon also present on the call. No clinical guidance was given and no surgical decision was influenced. What it demonstrates is that surgeons in separate locations can view and mark up the same operative field in real time.

Optimizing IOL Formula Performance in Atypical Eyes

Insights from studies evaluating patients with a history of scleral buckle surgery or short axial lengths.

Edward Manche, MD, Quentin B. Allen, MD

Cataract and Refractive Surgery Today

A Potential Digital Co-Pilot in the Retina OR

AI systems may one day augment traditional surgical workflows to improve efficiency and patient outcomes.

Stanley Poh, MBBS, MMed (Ophth), FRCOphth, FAMS, and Daniel Ting, MD, PhD

Retina Today

KEY TAKEAWAYS By analyzing large volumes of data, AI could generate clinically meaningful insights to enable more informed decision making in the OR. AI could identify high-risk cases and flag factors such as suboptimal glycemic control, anticoagulant use, medical comorbidities, drug allergies, and mobility limitations. Agentic AI can act as a digital co-pilot by integrating preoperative, intraoperative, and postoperative capabilities. Vitreoretinal surgery is a complex discipline involving intricate and highly variable pathology. Many decisions depend on dynamic changes in anatomy and tissue behavior, surgical visualization, and potential complications. As such, vitreoretinal fellows face a steep learning curve. Years of training through residency, fellowship, and independent surgical practice are required to develop the judgement needed to determine whether surgery is warranted, which intervention is most appropriate, and how urgently it should be performed. As AI tools proliferate and improve, they could advance the evolution of the retina OR. By analyzing large volumes of clinical, imaging, and procedural data, AI could generate timely, clinically meaningful insights to enable more informed decision making across preoperative, intraoperative, and postoperative phases of care (Figure). In many ORs, digital visualization systems and intraoperative OCT have already broadened what surgeons can see and have influenced surgical decision making.