CHENNAI: Dr Mohan Rajan does around 20 cataract surgeries on a busy day. Quite a task for any eye surgeon to bend down and look into the microscope while peeling off the clouded natural lens from behind the cornea. Not anymore.
Now, he wears polarised glasses, watches a giant, high-definition 3D TV screen, and does the surgery standing by the bedside of the patient. That’s how an AI-assisted three-dimensional surgical visualisation system works.
The 3D visualisation technology assisted by AI is used in various surgical procedures, including cataract and retinal surgeries. The technology is nascent in India, and only a few hospitals are currently using it.
Advantages Galore
It has many advantages over traditional surgical microscopes, such as improved depth perception and enhanced visualisation, which improve surgical outcomes. It also enhances the ability to record and share surgical procedures for educational purposes, said Rajan, chairman and medical director, Rajan Eye Care Hospital.
The equipment includes a high-definition 3D display, a camera mounted on the surgical microscope, and specialised software to process and display the 3D images. Surgeons wear polarised glasses to view the 3D images on the display. The surgery can be simultaneously viewed by multiple people wearing polarised glasses in the operation theatre. Heads-up 3D visualisation requires specific training for surgeons.
Overall, the technology has the potential to enhance the precision, safety, and educational aspects of cataract and retina surgeries, benefiting both surgeons and patients, added Rajan. Doctors have performed around 3,000 surgeries since it was introduced at the Rajan Eye Care Hospital. Almost all eye surgeries, from simple cataracts to complicated surgeries, are performed using 3D technology, the doctor said.
Dr. S Soundari, Regional Head of Clinical Services at Dr. Agarwals Eye Hospitals, said it is a good tool for teaching postgraduate students.
In case of a microscope, only one person can use it at a time, but on the 3D screen, around 10 people can stand around and watch the surgery and learn things. It provides the depth of the eye, which is very important for eye surgery.
Dr. Agarwal’s Hospitals, which used it as a demo recently, has plans to buy one, says Soundari.
“The cost of the tool is around `4 crore, but we don’t charge additional money from the patient for using the technology,” said Rajan, adding that the outcomes of the surgeries are good.
Given that eye surgery is one of the most delicate microsurgeries, 3D visualisation, deep learning algorithms, and AI have the potential to revolutionise surgical outcomes, said Dr. Shibal Bhartiya, additional director, ophthalmology, Fortis Memorial Research Institute, Gurugram.
“AI demonstrates exceptional proficiency in the acquisition, interpretation, and extrapolation of the extensive digital data generated during surgeries. This means the surgeon is guided by the machines to make better, more precise, and safer surgical choices. AI, therefore, helps attain better post-operative vision and helps customise the surgical plan, thereby enabling personalised treatment and enhancing surgical precision and safety. This is because AI optimises surgical outcomes and minimises adverse effects by selecting the most suitable method for each patient,” she said.
Cost Benefits
On cost effectiveness, Bhartiya said robotic surgery and AI-guided machines add to the surgical cost. It is often twice that of conventional surgery. As of now, cost-benefit analyses haven’t been conclusive.
“They also add to the surgical time; however, better patient safety and possibly better surgical outcomes mean that there is a lot of enthusiasm about these innovations,” she said.
Areas where AI has found use are refractive surgeries (to correct vision so that spectacles can be eliminated), cataract surgery, keratoplasty (corneal transplantations), and vitreoretinal surgeries, among others.
What to look for
depth perception and enhanced visualisation
Surgery can be viewed simultaneously by multiple people wearing polarised glasses
It has the potential to enhance precision, safety, and educational aspects of cataract and retina surgeries
Helps surgeons make better and safer surgical choices
(With inputs from Ashish Srivastava)