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Apple Vision Pro as the Intended Primary Intraoperative Visualization Platform for Complete Cataract Surgery: A
Tommy S Korn1,2,3, Cheyenne Santiago1,3, Yvonne Fuller1,3
1Department of Ophthalmology, Sharp Rees-Stealy Medical Group, San Diego, CA, USA.
Purpose:
To evaluate the feasibility and early safety observations of Apple Vision Pro as the intended primary intraoperative visualization platform during cataract surgery.
Patients And Methods:
This prospective, single-center, single-arm feasibility study evaluated Apple Vision Pro integrated with a ZEISS ARTEVO 850 three-dimensional digital surgical microscope. Forty-five patients undergoing cataract surgery were enrolled. Apple Vision Pro was used as the intended primary visualization platform, with conventional microscope oculars and an ARTEVO 850 three-dimensional monitor available as backup. Primary endpoints were procedure completion without device-related conversion and device-related intraoperative complications. Secondary endpoints included surgeon-reported workload and usability, operating room staff experience, and postoperative visual outcomes.
Results:
Forty-four of 45 procedures (97.8%) were completed using Apple Vision Pro without device-related conversion. One procedure required conversion to backup visualization after a transient image interruption perceived as image freezing; no patient harm or surgical complication occurred. No device-related intraoperative surgical complications were observed, although the study was not powered to assess rare complications. Mean patient age was 70.6 ± 8.8 years, and mean operative time was 15.4 ± 4.9 minutes. Mean best-corrected visual acuity improved from 0.50 ± 0.40 logMAR preoperatively to 0.02 ± 0.07 logMAR at 1 month. Surgeons reported low perceived workload on the modified NASA Task Load Index, and operating room staff reported minimal workflow disruption.
Conclusion:
In this prospective single-center feasibility cohort, Apple Vision Pro enabled completion of most selected cataract procedures using the intended primary visualization pathway within a defined workflow with immediate backup visualization. These preliminary findings suggest that wireless, head-mounted stereoscopic visualization may be feasible in a specialized, backup-supported surgical environment and support further controlled evaluation. However, these data cannot guide universal routine practice or establish comparative safety, clinical advantage, ergonomic benefit, routine clinical suitability, cross-specialty applicability, or detection of rare complications.
