Recent advances in ophthalmic surgery have enabled millions of people to regain or improve their vision. With innovative procedures in cataract surgery to corneal transplants, ophthalmic surgeries have become increasingly safe and effective as these new technologies enhance precision, accessibility, and patient outcomes. A few of these new technologies are highlighted below.

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1. ‍Robotic-Assisted Surgery: Robotic-assisted surgery has been a game-changer in various medical specialties, and ophthalmology is beginning to harness its potential. Robots can offer exceptional precision and steadiness, which can be crucial in delicate eye surgeries. For instance, the Preceyes Surgical System is being used for surgical retina procedures such as subretinal injection of gene therapy and to peel epiretinal membranes in the macula. Although still undergoing studies, another technology, the Intraocular Robotic Interventional Surgical System developed in the US aims to completely automate cataract surgery¹ .
   
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2. Artificial Intelligence (AI) in Surgical Planning: AI is being integrated into ophthalmic surgery to enhance preoperative planning and intraoperative decision-making. Machine learning algorithms can analyze vast datasets of patient information and suggest personalized treatment plans in cataract surgery. For refractive surgery, AI algorithms can be used to optimize the characteristics of the laser(s) used. This not only improves surgical accuracy but also reduces the risk of complications^2–4.
   
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3. 3D Printing: 3D printing technology can significantly contribute to ophthalmic surgery through the creation of models for surgical simulation and planning prior to surgery or for educational purposes. 3D printing may also allow for the development of more precise implants for patients with orbital floor fractures or for making more customised prosthetic devices. Although still in the experimental phase, 3D printing technology has shown potential for the development of eye tissues such as the cornea, to replace defective ones in patients⁵.
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4. Non-Invasive Glaucoma Treatments: Glaucoma, a leading cause of blindness, often requires invasive surgical procedures to manage intraocular pressure. However, non-invasive treatments are emerging as a promising alternative. Micro-stents and laser therapies can help improve aqueous humor drainage without the need for traditional incisions.These procedures are safer and more accessible, making glaucoma management more convenient for patients⁶.
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5. Telemedicine and Remote Surgery: The COVID-19 pandemic accelerated the adoption of telemedicine in healthcare, including ophthalmology. Telemedicine may be used for initial consultations prior to ophthalmic surgery. As well, a recent study utilized virtual surgical skills training to improve trainees’ surgical skills, suggesting that telemedicine can assist with training ophthalmic surgeons. Importantly, telemedicine and remote surgery has the potential make ophthalmic surgery more accessible to trainees from diverse backgrounds and expand patient access to specialized eye care, for example, for patients who cannot easily travel to eye centres ⁷.

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In conclusion, innovations in ophthalmic surgery can transform the field in the coming years. From robotic-assisted surgery to telemedicine and remote surgery, these advancements hold promise for safer, more precise, and more accessible eye surgeries. As technology continues to evolve, the future of ophthalmic surgery offers hope to millions of individuals with vision impairments and eye disorders.

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Author: Chidalu Edechi

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References:

1. Robotics in Ophthalmology. CRSToday. Accessed October 1, 2023.https://crstoday.com/articles/june-2023/robotics-in-ophthalmology
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2. Uses of artificial intelligence in ophthalmology. Eye News.Accessed October 1, 2023.https://www.eyenews.uk.com/features/ophthalmology/post/uses-of-artificial-intelligence-in-ophthalmology
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3. Jayadev C, Shetty R. Artificial intelligence in laserrefractive surgery – Potential and promise! Indian J Ophthalmol.2020;68(12):2650-2651. doi:10.4103/ijo.IJO_3304_20
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4. Lindegger DJ, Wawrzynski J, Saleh GM. Evolution andApplications of Artificial Intelligence to Cataract Surgery. Ophthalmol Sci.2022;2(3):100164. doi:10.1016/j.xops.2022.100164
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5. Personalized Medicine Goes 3D. American Academy ofOphthalmology. Published January 6, 2022. Accessed October 1, 2023.https://www.aao.org/eyenet/article/personalized-medicine-goes-3d
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6. Mercieca K, Figus M. Advances in Glaucoma Surgery. J ClinMed. 2023;12(3):828. doi:10.3390/jcm12030828
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7. Gupta C, Henein C, Ashton C, Makuloluwa A, Mathew RG.Development of virtual ophthalmic surgical skills training. Eye.2023;37(2):290-296. doi:10.1038/s41433-021-01896-1
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8. Image obtained from: https://www.leica-microsystems.com/applications/medical/ophthalmology/.