'Seeing both sides': A systematic review of the Miyake-Apple video system's role in ophthalmology

The Miyake-Apple technique for retrolenticular video analysis has proven itself to be a valued tool in research and education for anterior segment surgery, intraocular lens (IOL) design, implantation techniques and evaluating surgical complications. Such a knowledge base could also be incorporated into surgical simulators which are generally more readily available to training ophthalmologists. We identified 139 papers in the initial search. After screening 100 papers, 94 were included in the review. In all 94 studies, the employment of the Miyake-Apple technique for visualization was used for post-mortem eye analysis, yielding information about its role in (1) teaching and training, (2), understanding the effects of IOL implantation, (3), visualizing the impacts of experimental surgical techniques on the eye, and (4), its modern technical advancements to facilitate Miyake-Apple views with lower-resource endoscopic equipment. Our findings support the conclusion that the Miyake-Apple system can play an imperative role in the training and testing of ophthalmic surgeons, devices and surgical techniques. This technology has the potential to aid in the development of newer IOL explantation and replacement techniques as well as IOL fixation techniques. With advancing technology and innovative endoscopic posterior viewing techniques, barriers have lowered for adopting the Miyake-Apple system in ophthalmic surgical training globally.