ZEISS ARTEVO 800 in the OR: Better Posture, Shared Perspective

For generations, the fundamental posture of a vitreoretinal surgeon has been fixed: hunched over the oculars of a microscope, our bodies contorted for hours on end. It’s a position that has led to chronic neck and back pain for many in our profession—in fact, 14% of retina surgeons in a 2020 study reported that they planned to retire early due to musculoskeletal issues.¹

When our institution invested in ZEISS ARTEVO 800, the heads-up 3D digital microscope, the initial draw was the promise of a more ergonomic surgical experience. What I discovered was a technology that not only improved my physical well-being but also fundamentally changed the educational and collaborative dynamics of my OR.

The most immediate change with ZEISS ARTEVO 800 is the transition to a heads-up posture. Instead of looking down through the oculars, I sit back comfortably and view the surgical field on a large 4K 3D monitor (Figure). The ergonomic benefit has been substantial. I operate in a neutral, relaxed posture, which reduces fatigue during long, complex cases.

The benefits of ZEISS ARTEVO 800 visualization extend beyond personal comfort. One collective benefit is that everyone in the room sees exactly what I see. My fellows, residents, and medical students no longer try to get a glimpse through an assistant scope with a limited field of view. Rather, they are completely immersed in the procedure, watching my every move on the main screen. This creates a much more productive and relaxed teaching environment. I can guide a fellow through the delicate process of an internal limiting membrane (ILM) peel, and they can appreciate the subtle tissue interactions in high definition. We discuss strategy and tactics in real time, and the entire team (including the scrub technicians and nurses) develops a better understanding of the operation's flow.

Some skeptics of heads-up 3D surgery have pointed to the potential for a lag between action in the eye and visualization on the monitor. However, in my estimation, there is no noticeable lag time between movements in the eye and their depiction on the monitor. Further, resolution is high: I’ve found that the digital view provides a crisp, clear image that supports the fine motor control and precise maneuvers required for retinal surgery.

While ZEISS ARTEVO 800 is a fully digital system, it retains the option of traditional oculars. For surgeons who are adopting heads-up surgery, this optionality provides a bridge between traditional and fully digital surgery. While I almost exclusively rely on heads-up visualization, I still rely on oculars for specific use cases (e.g., when applying peripheral laser). Further, I know I can always switch to the oculars if I have technical difficulties with the monitor.

Ultimately, adopting ZEISS ARTEVO 800 has made my surgical days less physically demanding, enriched the learning experience for my trainees, improved surgeon-staff interaction, and provided a high-quality view of the surgical field that supports the precision our specialty demands. If these benefits match your priorities, consider adopting ZEISS ARTEVO 800 visualization.

To learn more about ZEISS ARTEVO 800 and ZEISS ARTEVO 850 in retinal surgery, visit the ZEISS ARTEVO 850 page on ZEISS.com.

^{The statements of the author reflect only his personal opinions and do not necessarily reflect the opinions of any institution with whom he is affiliated.
The author has a contractual or other financial relationship with Carl Zeiss Meditec, Inc. and has received financial support.}