Intraocular illumination – opportunities and risks of novel approaches

Abstract

Purpose : In 2015 the authors were presented with EURETINA European Society of Retina Specialists Innovation Award for their idea to directly place LEDs within the eye during intraocular surgery. Thus better and safer illumination should be reached. The results of their research over the last 4 years is presented. Due to availability of novel LED illumination systems ophthalmologists must consider their impact on patients. Various aspects of LED light when either used as an intraocular light source during surgery or a transscleral illumination system are discussed. Possible hazard of light to the retina and critical parameters will be identified.

Methods : Novel LED illumination concepts have been developed by integration of micro-SMD LED and SM-LED into trocars and diaphanoscopes. The physical effects of the LED illumination have been studied by exposing both porcine and human eyes to various light sources.

Results : An anterior to posterior examination revealed a location and pressure dependent transmission of human and porcine sclera. Furthermore pressure dependent direct trans-tissue transmission of eyewall, sclera and vitreous body in the range of 350–1050 nm was confirmed. It was shown that there exists a higher risk of light-induced retinal damage due to increase of intraocular irradiance by endoillumination.

Conclusions : Novel LED based light sources offer a great potential for innovation in the ophthalmic environment. The results of our studies showed that the existing regulations should be reconsidered to further enhance patient safety. Because all our studies have been done in ex vivo settings the next step should be a human in vivo study to determine for surgical purposes relevant data.

This is a 2021 ARVO Annual Meeting abstract.