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Spencer Fuller, Hideki Fukuoka, Natalie A Afshari; Video Recording and Light Intensity Analysis during Cataract Surgery Simulated from the Patient’s Perspective. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1810.
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© ARVO (1962-2015); The Authors (2016-present)
Patients who undergo cataract surgery often describe visual phenomena during the procedure. The best understanding of intra-operative visual experiences derives from patients’ descriptions and artists' renditions. We set out to visualize and capture intra-operative visual phenomena during cataract surgery. In addition, we hypothesized that photographs from the footage could permit quantified estimates of changes in patients’ light exposure during surgery.
Post-mortem porcine eyes were fixed on a surgical tray, and video recording of cataract surgeries was accomplished using a plastic-covered, front-facing iPad Air (MD785LL/B) camera via the ManualShot iPad Application (REU Limited Version 1.0.1). Video footage of cataract surgeries was obtained from six eyes filmed through a maculostomy—a small hole made at the site of the macula through the posterior aspect of the globe. Photographs at pre-determined points during surgery were extracted from the footage. The Mean Gray Value (MGV), a summary statistic of the image’s light intensity, was obtained using the open-source, validated FIJI image processing package distributed by ImageJ (v. 1.51h, National Institutes of Health).
We obtained video footage and 24 images for light intensity analysis. When compared to baseline light intensity prior to surgery, the percentage increase or decrease in light intensity was -10% when AC = 0, +42% when AC = full, -94% after application of Trypan blue, -9% after Trypan blue removal, -47% after phacoemulsification, and -2.5% after IOL placement (Alcon MTA4UO 23.0 D). The step of cataract surgery associated with the highest increase in light intensity compared to the previous step was when Trypan blue was removed after Trypan blue application (+1,432%), and the second highest increase in light intensity was after IOL placement following phacoemulsification (+86%).
Our data demonstrates that average light intensity after cataract surgery is similar to intensity prior to surgery, and reveals that light intensity exposure varies greatly during surgery. Our video footage, photographs, and data on changes in light exposure during cataract surgery may serve as informational and educational tools for physicians, residents-in-training, and patients alike.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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