Cataract surgery with Verion – A quick review of my experience

Some time ago I wrote about the use of the SMI system for cataract surgery. The SMI system is a computer assisted method of guiding cataract surgery. Essentially it allowed visualisation of intraocular lens alignment, wound location and capsulorhexis size.

Whilst this system was certainly better than “eyeballing” it, it tended to be unpredictable and erratic.

Alcon subsequently bought the SMI system and used it as the basis for their new Verion system. Essentially it is SMI on steroids.

Today I had the opportunity to give it a trial run and I was quite impressed.

So what does Verion do? Well it is technology that images the eye on the day of surgery and is able to capture information about the cornea such as keratometry and vessel landmarks.

This information is then displayed as a Heads Up Display (HUD) in the surgeons left eye. Thus when looking through the operating microscope, the display is visible and appears as superimposed on the patients eye.

By use of a foot pedal one can sequentially change the view to allow various different parameters to be displayed. In my trial, I initially was able to see a cursor that showed me where to place my main wound. I was then able to call up the capsulorhexis which was set to 4.8 mm but can be set to whatever is desired. Finally an alignment mark is able to be called up to show where the axis of the toric lens should be placed. In my Femto cataract cases, the main wound and rhexis had already been performed so it was used to align the toric lens.

My usual procedure is to mark the eye with a texta colour with the patient sitting up prior to surgery at the twelve and 3 o’clock positions. I then mark the toric axis with the patient on the table. Patients usually don’t like being marked as it is irritating so this saves on that.

Unlike the SMI, I found the Verion to be quicker in acquisition and more stable in displaying the information. I found that the SMI would often incorrectly identify the limbus, instead locking on to the the pupil. This problem seems to have been fixed.

No it is not intraoperative aberrometry but it is certainly a step forward in better alignment and easier surgery

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