A critical element in any successful surgical procedure is the ability to visualize the tissue being manipulated surgically. I have often said to my fellows that while steady hands are definitely an asset, ophthalmic surgery is a “visual sport,” and seeing clearly what is being operated upon is critical to a successful outcome. During my residency training, many surgeons were still using loupes for intracapsular cataract extraction while others were pioneering the use of the operating microscope. The operating microscope changed the way we see in ophthalmic surgery, and for 40 years we have benefited from ever better optics and illumination.The access a few years back of a Zeiss Lumera was, for me, the latest amazing advance in operating microscopes, allowing me to see detail I never before observed during surgery. In addition, we now have 2-D and 3-D video projection technology that can magnify any object of interest and even provide surgical templates for guidance. Many of our surgeon colleagues in other fields have transitioned to these as preferable over direct observation, and a few ophthalmic surgeons are evaluating the benefit of this approach in ocular surgery.
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