Use of Black-and-White Digital Filters to Optimize Visualization in Cataract Surgery

Abstract

Purpose: To evaluate the effect of a black-and-white (BW) filter on the optimization of visualization at each stage of cataract surgery. Methods: Prospective, single-center, single-surgeon, consecutive case series of 40 patients undergoing cataract surgery with BW filter. Surgical images and videos were recorded with and without the BW filter at each stage of cataract surgery. Contrast measurements of surgical images and subjective analysis of video sequences were performed. Results: The surgeons assessed the BW filter to optimize the tissue visibility of capsulorhexis contours, hydrodissection fluid wave perception, the contrast of instruments through a nucleus during phaco-chop, and subincisional cortex contrast through the corneal edema. Despite the higher contrasts’ value obtained with BW filter images during nucleus removal, posterior capsular polishing and viscous removal, the surgeons subjectively reported no significant advantage of using a BW filter. Standard color images were found to be better for localizing the limbal area during incision and for nucleus sculpture to assess groove depth. Conclusions: In conclusion, we describe here the potential indications for BW filter use at particular stages in cataract surgery. A BW filter could be used, with caution, in cases of poor visualization.

Use of Digital Methods to Optimize Visualization during Surgical Gonioscopy

“…Digital technology makes the use of color filters during surgery possible, resulting in better contrast and, thus, a clearer visualization of structures. Several studies have reported improvements in visualization with digital images for both cataract surgery and epiretinal membrane staining during surgery [9,[12][13][14].…”

“…Color saturation was slightly decreased digitally to improve contrast. It has been reported that decreases in color saturation can improve the delimitation of tissue contours in visualizations, facilitating internal limiting membrane peeling and enhancing visualization during cataract surgery [9,18].…”

“…In a prospective series, we recently demonstrated the utility of black-and-white filters for optimizing visualization during particular steps in cataract surgery in cases of poor visualization [9].…”

Evaluation of new approach to enhance visualization performance in cataract surgery: 3D visualization system with coaxial illumination

“…11,12 The black-and-white filter added in standard illumination optimized tissue visibility but also leaded to difficulties in nuclear sculpture and incision location. 13 We used the 3D-C approach to increase visualization performance during phacoemulsification. Both objective and subjective approaches are used to qualify the performance of the NGENUITY 3D visualization system in this study.…”

Operative Digital Enhancement of Macular Pigment during Macular Surgery

“…With this technology, digital filters can be applied in real time during surgery to increase contrast and improve the visualization of structures. Several studies have reported improvements in visualization with digital images for both cataract surgery and epiretinal membrane staining during surgery [ 14 , 15 ]. Here, we describe the feasibility of using digital visualization and its contribution to the enhancement of MP visualization and analysis in a prospective series of macular surgery interventions.…”