Bausch + Lomb has entered the field of ophthalmic microscopes in a big way – and a Brisbane hospital was Australia’s first to trial and install the fully digital surgical visualisation platform with some world-first features.
Ophthalmology can be a demanding job. A demanding workload and demanding patients can take a toll. Throw a musculoskeletal injury into the equation and the mental load can become that much greater.
Increasingly, the sector is shining the spotlight on the physical stresses of the job. In fact, a 2023 study of 514 eyecare professionals published in Cureus found 66.7% suffer from musculoskeletal pain.1 For ophthalmologists, it’s reported that more than half experience at least one type of pain, either in the lower back (39%) or neck (32.6%).1,2
Several factors are thought to contribute to this, such as working in the same posture for long periods, awkward posture, and bending the back.1,3 Studies have also noted the prevalence of lower back pain was high among ophthalmologists and healthcare professionals due to sitting for long periods that ultimately increases the chance of lower back pain by 1.5 times.1,4,5,6
Digital microscopy and heads-up displays have been heralded as a solution to this ergonomics problem, allowing surgeons to sit straight without straining the neck and back. But this is only part of the picture, with the next wave of microscopes also offering new levels of visualisation, intuitive interfaces, smoother workflows and an immersive educational experience.
Equipped with decades of experience in optical innovation, Bausch + Lomb (B+L) –in collaboration with digital microscopy pioneer Munich Surgical Imaging (MSI) that’s a wholly owned subsidiary of Heidelberg Engineering – had these issues in mind when developing its first-ever ophthalmic microscope. Launched in Europe and the US in April 2023 and now available in Australia, the SeeLuma is the company’s new fully digital surgical visualisation platform with a major advance being the world’s first digital binoculars.
It means the surgeon can choose between operating on a heads-up surgical monitor or can look through the binoculars that remain in the same position even when tilting the microscope head – such as during glaucoma surgery.
“In reality, other digital microscopes force you to operate while looking sideways at the monitor to perform surgery. These shortcomings mean that over half of ophthalmic surgeons report job-related neck or back pain with 15% finding that this limits their work7,” the company says.
“SeeLuma addresses this challenge with its C-shaped suspension arm which enables surgeons to view the 3D 55-inch and 31-inch 4K monitors straight ahead of them. The fully digital binoculars can be positioned freely, allowing you to take an ergonomic posture and work with greater ease.”
B+L’s first installation of SeeLuma in Australia was at the Mater Private Hospital Redland in Brisbane where Dr Sunil Warrier and his team trialled the system. The hospital then purchased the microscope in 2024.
“Visualisation and depth of field were amazing, not just for cataract but also glaucoma surgery,” he says, noting that better visualisation leads to neater, cleaner surgery and therefore improved recovery and outcomes.
“This is more than just a trial; it’s a leap forward in our shared vision for the future of eyecare.”
The SeeLuma’s premium image quality, according to B+L, is brought about by its colour reproduction, contrast, and resolution, along with a 9x depth of field enhancer, that can enable surgeons to confidently tackle complicated surgical cases, with cinematographic-quality visualisation.
In addition, it comes with two separate 3D 4K monitors: the main 55-inch display, and a stand-mounted 31-inch display.
Whether controlled by nurses on the e-rack or by the operating surgeon using the footswitch, SeeLuma also provides a fully integrated system that enables control of system parameters, helping to optimise workflow.
B+L says an example of this is the ability to work “harmoniously” with the OCULUS BIOM 5c binocular indirect ophthalmoscope for fundus viewing. In this case, it can automatically adapt parameters such as zoom, focus speed, white balance, image inversion, and footswitch layouts, allowing the user to continue surgery without interruptions.
Professor Marco Mura, chair of the Department of Ophthalmology at University of Ferrara in Italy, performs many complicated surgeries requiring precision and optimal visualisation. With SeeLuma, he can see some retinal structures and pathology in greater detail than other microscopes he has used.
“What I like about the SeeLuma is the huge depth of field it offers. You are able to basically see the periphery of the retina and the posterior pole in the same image without the need to refocus,” he says.
“Another advantage is the possibility of a digitally manipulated image. For example, a recent case was a quite complex peeling of the epiretinal membrane, and the structure was very transparent. It was not colouring very well. With the SeeLuma, you can apply a filter which enhances the blue colour to be able to remove the membrane in a safe way.”
For Dr Alain Saad, ophthalmologist at Rothschild Foundation Hospital in Paris, the SeeLuma’s image quality has been a standout.
“I was a little reluctant [to try it], because I’ve tried other systems and whenever you have something new, you always wonder if it’s as good as what we already have. It was not only as good, it was a little superior,” he says.
Dr Saad also lauded the system’s usability, with an impressive number of parameters controllable on the foot pedal.
“You can also project many things to your assistant, fellow or resident who will be able to see that and reproduce the movement, so it has very high capability in teaching. What’s interesting is the frequency of the acquisition is very high, so it follows exactly the movement and the quality of the image is great.”
According to B+L, surgery can be recorded in 2D or 3D formats prior to being exported. This recording functionality, and the heads-up display configuration, make SeeLuma ideal for teaching situations, as Dr Saad has suggested.
“Surgeons can connect multiple wireless displays simultaneously, allowing trainees and stakeholders to follow and anticipate surgical steps as they occur, in-person and remotely,” B+L says.
“Offering real-time support via a touch screen interface, the Assist Mode feature allows users to make annotations or notes on the surgical image, enabling cutting-edge collaboration during live surgery.”
References:
1. Al Taisan A, Al Qurainees AE, Al Sowayigh OM, Al Owayfir MA. Musculoskeletal Pain Among Eye Care Professionals. Cureus. 2023 May 23;15(5):e39403. doi: 10.7759/cureus.39403. PMID: 37362510; PMCID: PMC10287028.
2. Symptoms of musculoskeletal disorders in ophthalmologists. Dhimitri KC, McGwin G Jr, McNeal SF, et al. Am J Ophthalmol. 2005;139:179–181.
3. A survey study of musculoskeletal disorders among eye care physicians compared with family medicine physicians. Kitzmann AS, Fethke NB, Baratz KH, Zimmerman MB, Hackbarth DJ, Gehrs KM. https://pubmed.ncbi.nlm.nih.gov/21925736/ Ophthalmology. 2012;119:213–220.
4. Prevalence and associated factors of low back pain among physicians working at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia. Al-Ruwaili B, Khalil T. https://pubmed.ncbi.nlm.nih.gov/31844441/ Open Access Maced J Med Sci. 2019;7:2807–2813. [PMC free article] [PubMed] [Google Scholar]
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6. Self-reported musculoskeletal disorders and quality of life in supermarket cashiers. Algarni FS, Alkhaldi HA, Zafar H, Kachanathu SJ, Al-Shenqiti AM, Altowaijri AM. https://pubmed.ncbi.nlm.nih.gov/33322079/ Int J Environ Res Public Health. 2020;17:9256. [PMC free article] [PubMed] [Google Scholar]
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