Revolutionizing the Way Eye Surgeons See with NGENUITY

Revolutionizing the Way Eye Surgeons See with NGENUITY

The NGENUITY 3D Visualization System from Alcon provides unprecedented 3D visualization of the back of the eye, with greater depth and detail during surgery than traditional microscopes.

In fact, a theoretical assessment by Lu Yin, Data Science and Digital Solutions, Alcon, compared three analog microscopes with NGENUITY. He found that NGENUITY can provide 26% to 48% higher total magnification; up to 5-fold greater instantaneous depth of field; and 11% to 42% better depth resolution than scopes. Additionally, NGENUITY provides this higher level of magnification, without compromising depth of field. 

According to Dr. Shrinivas Joshi from the MM Joshi Eye Institute in India, NGENUITY is also superior to analog scopes for peripheral work thanks to the illumination provided by the chandelier. “It gives fantastic visualization, even when working at the periphery, an area where the analog microscope is lacking,” he explained, adding that this particular advantage of NGENUITY has proven to be a game-changer for him and his practice – and is the reason he uses NGENUITY. 

Dr. Joshi also presented findings from a study that compared the high magnification performance in NGENUITY to an analog microscope. Results showed that the conventional microscope scored 79%, while NGENUITY received 89% for best performance, with a P-value that was statistically significant.

NGENUITY: An Intraoperative Advantage

For complicated or delicate procedures like cannulation or transplantation, Dr. Kazuaki Kadonosono from Yokohama City University in Japan, says the NGENUITY is exceptional: “The contact lens gives higher magnification, which allows for better (and higher) resolution than under a conventional microscope.” 

Further, Dr. Lim Kian Seng, an international specialist at Eye Center Malaysia, says that “understanding the system is very, very important for surgeons to see its capabilities and great potential”. To illustrate this point, he presented a case of a combined cataract with macular hole – and his first use of a cannula. 

“With more experience, I began to understand the system better,” said Dr. Lim. “The valve cannula allowed better control of intraocular pressure before the commencement of the phaco surgery; and by optimizing elimination, I could actually see the continuous-tear curvilinear capsulorrhexis extremely well, in real time.”

From there, Dr. Lim showed how easy it is to stain the internal limiting membrane (ILM) with NGENUITY; and how to use an extrusion cannula to properly control intraocular pressure (IOP) while gas is injected into the eye. “This results in a very controlled combined phaco and vitrectomy for macular hole surgery,” he concluded.

Settings for Success

Maximizing the view on the NGENUITY system involves visual resolution, depth of field and depth of resolution. Depth of resolution is particularly important for peeling ILMs or epiretinal membranes, and during macular hole surgery.

For optimum visualization, Dr. David Chow from the University of Toronto, Toronto Retina Institute, Canada, recommends a viewing distance of 1.2 meters and a camera aperture of 30% (to allow for maximum depth of field). Dr. Chow adds that “maximal macular magnification should be used whenever possible, while a light pipe power of 20% should increase safety without sacrificing visibility benefits”.

Vision for the Future

Not only has NGENUITY shown superiority over conventional microscopes, its functionality – and versatility – has provided further benefits to both patients and surgeons alike. 

“NGENUITY as used in the clinical setting has a series of benefits, from clearer views of surgery, improved surgery ergonomics, to its teaching capabilities,” said Dr. Joshi. 

“Enhanced depth of field enabled with NGENUITY has resulted in both a clearer front and back view of the eye during surgery, and the underexposed and the overexposed images both blend together to provide exceptional image systems,” he continued, adding that with NGENUITY surgical ergonomics have also improved. “Nearly 70% of ophthalmologists have experienced neck, back or shoulder injuries,” said Dr. Joshi. 

NGENUITY is also an excellent teaching tool, enabling fellows, residents and technicians to watch a surgery while it’s being performed. 

It’s clear that digital technology like NGENUITY is revolutionizing the way retina surgeons operate – and these advances will continue to drive improved patient outcomes.  

Editor’s Note: Reporting from this story took place at amplifEYE, an Alcon-sponsored event to share user experience with NGENUITY, in Hong Kong on March 4, 2019.

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