'Seeing Both Sides': A Systematic Review Of The Miyake-Apple Posterior Video System’S Role In Ophthalmology
Published 2025 - 43rd Congress of the ESCRS
Reference: PO807 | Type: Poster | DOI: 10.82333/tm5f-f756
Authors: Alexander Maloof* 1 , Shane Zhang 2 , Nichola Pavic 3 , Minas Coroneo 1
1Department of Ophthalmology,Prince of Wales Hospital,Sydney,Australia, 2Royal North Shore Hospital,Sydney,Australia, 3College of Medicine and Public Health,Flinders University,Adelaide,Australia
Purpose
The Miyake-Apple technique for posterior eye video analysis has proven itself to be a valued tool in research and education for anterior segment surgery, intraocular lens (IOL) design, implantation techniques and evaluating surgical complications. This systematic review examined the role of the Miyake-Apple system for simultaneous posterior and anterior imaging during anterior segment surgery in ophthalmic research and surgical training.
Setting
University of New South Wales, Sydney, Australia.
Methods
A systematic review was conducted in accordance with the PRISMA2022 reporting guidelines. We identified articles describing use of the Miyake-Apple technique for posterior visualization by systematically searching PubMed, Medline, EMBASE and SCOPUS, on November 7, 2024. The Cochrane’s collaboration tool for randomized controlled trials, the Newcastle-Ottowa checklist in observational studies were employed for risk of bias assessment.
Results
We identified 139 papers in the initial search. After screening 100 papers, 94 papers were included in the review. In all 94 studies, the employment of the Miyake-Apple technique for visualization was used for post-mortem eye analysis, yielding information about its role in (1) teaching and training, (2), understanding the effects of IOL implantation, (3), visualizing the impacts of experimental surgical techniques on the eye, and (4), its modern technical advancements to facilitate Miyake-Apple views with lower-resource endoscopic equipment
Conclusions
The findings of this review support the conclusion that the Miyake-Apple system can play an imperative role in the training and testing of ophthalmic surgeons, devices and surgical techniques. The Miyake-Apple technique enhances ophthalmology by aiding the development of intraocular lens explantation, replacement, and fixation techniques, and should be employed in wet labs and surgical simulators for education and training in anterior segment surgery. With advancing technology and innovative endoscopic posterior viewing techniques, barriers have lowered for adopting the Miyake-Apple system in ophthalmic surgical training globally.