Part 4: Improving surgical performance with an AI-based application


In 2022, having completed my residency, I began working as a specialist at the Eye Day Clinic in Rheine, Germany. Like other young ophthalmologists beginning a career in cataract surgery, I wanted to further improve my surgical skills to be able to provide my patients with the best possible outcomes. I felt fortunate that Dr. Florian Kretz, the clinic’s medical director, was my mentor as I continued my surgical training. In addition, I quickly found benefit from using the new ZEISS Surgery Optimizer.

Video 1. ZEISS Surgery Optimizer – What it is and how to use it?

ZEISS Surgery Optimizer is an innovative artificial intelligence (AI) and cloud-based application that takes both the opportunity for self-learning from surgical video review and the experience to a whole new level.

Watching intraoperative recordings of one’s own cataract surgeries and of those performed by more experienced colleagues is a well-recognized method by which surgeons can identify ways to refine their skills, improve surgical efficiency, and reduce risk of complications. Its use, however, may be limited by the complexity and time-consuming tasks of exporting and accessing the materials. The ZEISS Surgery Optimizer revolutionizes the entire process by providing surgeons easy access to surgical videos on their personal devices without having to manually export and import the files. Once a case is completed, surgeons simply have to click a button to import the recording from ZEISS CALLISTO eye to a cloud-based software system. Personal surgical videos along with those uploaded and authorized for sharing by other cataract surgeons are then immediately available for viewing on a computer via a web browser or on a mobile device using the ZEISS Surgery Optimizer (Video 1).

While using ZEISS Surgery Optimizer, surgeons have all their case videos at their fingertips (Figure 1A). The screen displays the video along with patient data, including date of surgery, biometry data from ZEISS IOLMaster, surgery details from ZEISS CALLISTO eye and data, images, and documents from other diagnostic devices (Figure 1B). Using AI, ZEISS Surgery Optimizer segments the recorded case into phases (i.e. incision, OVD injection, capsulorhexis, hydrodissection, phacoemulsification, irrigation/aspiration, IOL implantation, etc.) that can be individually selected for review (Figure 1C). Clear case documentation details and easy database creation allow surgeons to readily search for cases based on specific features. In addition, with ZEISS Surgery Optimizer, surgeons can watch two videos side-by-side in split-screen view and thereby compare their technique during two of their own cases or between a case from their own library and one available from another user.

Figure 1. With ZEISS Surgery Optimizer you have access to all your surgery videos uploaded from the ZEISS CALLISTO eye (A). The application displays the recording of your surgery along with patient data (B). By clicking on “Phases”, surgeons can select and watch the clip of a specific surgical step (C).

Personal reflections - What I gained from ZEISS Surgery Optimizer

I cannot underscore enough how much I appreciate the easy and convenient access I have to my surgical videos using ZEISS Surgery Optimizer. In addition, the phase segmentation feature that allows me to concentrate on and compare my technique when performing specific surgical steps enhances my ability to learn from video review and makes learning more efficient. By using the phase selection feature and split-screen view to compare my technique with that of a more experienced surgeon helps me identify ways to refine my technique and improve my skills so that my surgery becomes more precise and more efficient (Video 2). Then using the same features to compare my performance on two of my own cases allows me to assess how I am doing on my learning curve.

Video 2. What I gained from ZEISS Surgery Optimizer - Comparing your own surgery performance with the performance of advanced surgeons

The recordings of complicated surgeries are of the greatest importance to me (Video 3). Being able to watch the video at the end of the day with my mentor when the case was fresh in my mind helped me understand what led to the complication and use what I learned to avoid it in the future.

Video 3. What I gained from ZEISS Surgery Optimizer - Learning from complications

Figure 2. The benefits of using an AI-based application for reviewing surgical videos


I am now just a few years into my career as a practicing ophthalmologist, and I still consider myself a beginner when it comes to cataract surgery. However, I can say definitively that thanks to its many features and advantages, ZEISS Surgery Optimizer is an outstanding teaching tool and has helped me to improve my cataract surgery skills (Figure 2). Going forward, I am continuing to take advantage of this excellent tool as I strive towards optimizing my outcomes for the benefit of my patients.

Supported by ZEISS
The statements of the authors reflect only their personal opinions and experiences and do not necessarily reflect the opinion of any institution that they are affiliated with. The authors alone are responsible for the content of their experience reported and any potential resulting infringements. Carl Zeiss Meditec AG and its affiliates do not have clinical evidence supporting the opinions and statements of the authors nor accept any responsibility or liability of the authors’ content.
The author Karen Glandorf has a contractual or other financial relationship with Carl Zeiss Meditec AG and its affiliates.

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