Disruptive innovation is defined as technology capable of altering the way consumers, businesses, or industries operate. With the introduction of its Beyeonics One, the first and only digital ophthalmic exoscope with a 3D augmented reality (AR) headset, Beyeonics Vision is offering ophthalmic surgeons a new visual reality—one with promise to improve how anterior and posterior segment surgeries are visualized (Figure 1).
In contrast to analog viewing systems, the Beyeonics One system provides an open, evolving surgical platform designed for continuous innovation. Transitioning to digital systems offers advantages like streamlined data consolidation and enhanced visualization. The innovative technology enables an immersive perspective of the surgical field, facilitated by its intuitive and user-friendly interface. The 3D headset allows surgeons to maintain a clear view of the surgical field while enjoying freedom of movement, with advanced and precise controls accessible through simple head gestures.
Beyeonics One offers seamless automation of features for both anterior and posterior segment surgeons, including automatic focus and centering, digital color filters, illumination controls, and digital markers, among others, thereby ensuring optimal visualization of the surgical field. Patient data are integrated into the surgical view, providing surgeons with crucial information in real time (Figure 2). Additionally, digital markers, such as toric markers, can improve surgical efficiency. Comprehensive image enhancement features like digital illumination and color filters improve the visibility of dyes and provide overall surgical site clarity.
Figure 2. Beyeonics One has the ability to display patient information, such as OCT images, within the headset.
In a recent interview, anterior segment surgeon Eric D. Rosenberg, DO, MScEng, and retina surgeon Thomas W. Stone, MD, shared their experience with the Beyeonics One system.
What is the value comparison between digital and analog viewing systems?
Eric D. Rosenberg, DO, MScEng: There is a contrast between the static nature of optical microscopes and the dynamic capabilities of digital ones. Digital microscopes are essential for the evolution of the field, particularly with the integration of machine learning and AI, which are not compatible with analog systems. Staying current with technological advancements, such as digital microscopy, is crucial for maintaining a competitive edge in the field.
Thomas W. Stone, MD: While optical systems may have durable optics, they simply can’t offer the advantage of improving performance through continuous innovation and updates. With digital systems, the headset enables me to look straight ahead, which is distinctly different than viewing the surgery on a monitor, which still requires the surgeon to pivot slightly for a good view. My physical posture is improved, and there is less strain on my neck at the end of the day.
How has Beyeonics One impacted your surgical workflow?
Dr. Stone: Like any new technology that gets integrated into a surgeon’s workflow, there is a slight learning curve to figure out all the settings and capabilities. But once you do, the potential is incredible. The system offers the ability to use lower light luminance, which translates to better safety for patients. Beyeonics One also positively impacts the ability to train new surgeons. As an attending, I’ve gained confidence by closely observing my fellow’s actions in real-time, allowing for more meaningful case discussions compared to traditional methods like side scopes or monitor viewing.
Dr. Rosenberg: In my practice, integrating digital visualization platforms like Beyeonics One has been pivotal for efficiency and operating speed. The advantage of Beyeonics One compared to other digital 3D monitor based systems is that the OR staff doesn’t have to move or adjust the device depending on which eye is operated on or my sitting position. The system stays fixed in one spot when patients enter the room, allowing for seamless transitions between procedures without delays, even in practices with multiple ORs.
The headset allows the surgeon to easily control parameters during the procedure. How does this feature improve surgical performance?
Dr. Rosenberg: The intuitive control functionality of the headset has truly revolutionized my surgical performance. With a simple pedal click and head gesture, I can effortlessly adjust parameters during procedures, depending on the dynamic nature of the case. This allows for quick transitions between different focal points and maneuvers, ultimately optimizing my surgical precision and efficiency.
Dr. Stone: The autofocus feature of the anterior segment is powerful, and I would add that the depth perception capacity on my anterior cases was nothing short of mind-blowing. It’s a big step up from analog scopes, which typically require a fair amount of adjustment along the Z-axis in the middle of cases. With Beyeonics One, a simple head gesture autofocuses my image, which is a simpler and time-saving way to operate.
How does the ability of the Beyeonics One to enhance images via color filters or by modulating the digital brightness impact surgical workflow?
Dr. Stone: I appreciate the ability to customize settings for better surgical field visualization. Although optimizing them for each case may require some trial and error, once set, they seamlessly integrate into my workflow. One of the strongest elements of a digital system is the way that it handles light. Surgeons can develop a natural proficiency in optimizing lighting and harnessing other digital features to elevate surgical outcomes.
Dr. Rosenberg: Digital illumination is much more comfortable for the patients and allows me to work through cases smoothly. In my experience, the light intensity of analog microscopes contributes to patients’ eye movement, which is problematic, especially in high-volume clinics that only use topical anesthesia.
What is your perspective on integrating a new device like the Beyeonics One in light of a more conservative market and audience?
Dr. Rosenberg: Adopting innovative systems like the Beyeonics One demands forward thinking, despite market conservatism. Evaluating available technologies is crucial for enhancing patient care and practice efficiency. There are two choices: embracing or ignoring new technology. With digital advancements rapidly transforming ophthalmology, ignoring innovation is no longer feasible.
The successful integration of a digital system depends on seamless workflow incorporation and addressing patient needs. With functionalities extending beyond traditional scopes to aid documentation, communication, and patient engagement, integration success hinges on careful consideration of practice goals, patient needs, and technological capabilities, ultimately enhancing care, streamlining processes, and ensuring competitiveness in the field’s evolving landscape.
Can you speak to any learning curve associated with setting up and integrating the Beyeonics One system into practice?
Dr. Stone: It’s not overly complex and typically requires a short time with the company representative for a demonstration. Since it functions like a microscope, staff members find it relatively easy to adapt. I like to research any new device before any patient interaction to ensure a smooth integration into our practice. There will be a learning curve associated with mastering all the capabilities of this system and using it to its full capabilities. Despite the initial learning curve, Beyeonics One has the potential to transform our surgical practices.
