First Combine Dmek/Cataract Surgery With 3D Headset Apple Vision Pro

To report the first combined Descemet Membrane Endothelial Keratoplasty (DMEK) and phacoemulsification procedure performed using a 3D augmented reality (AR) headset (Apple Vision Pro), and to evaluate its feasibility, intraoperative performance, and surgical ergonomics.

One surgical case done at the Rothschild Foundation in Paris. Vidéo included

A combined DMEK and cataract surgery was performed in a patient presenting with endothelial dysfunction and visually significant cataract. The procedure was conducted using a surgical microscope integrated with a 3D augmented reality headset (Apple Vision Pro). The headset provided real-time stereoscopic visualization with enhanced depth perception and allowed simultaneous multi-screen integration within the surgeon’s operative field of view (including anterior segment imaging, surgical parameters, and intraoperative data). Operative time, intraoperative events, and surgeon-reported ergonomics were assessed.

The combined procedure was completed without intraoperative or postoperative complications. Total operative time was comparable to standard combined DMEK–phacoemulsification procedures. The 3D AR system provided exceptional depth of field visualization, particularly during graft unfolding and centration. The integrated multi-screen interface allowed continuous access to critical surgical data without diverting gaze away from the operative field. The surgical workspace was effectively redefined, enabling interaction with essential digital displays within the surgeon’s direct line of sight. Surgeon-reported ergonomics and cognitive workflow were subjectively improved.

This first reported case of combined DMEK and cataract surgery performed using a 3D augmented reality headset demonstrates technical feasibility and safety, with operative time comparable to conventional approaches. Enhanced depth perception and integrated digital visualization may represent a paradigm shift in anterior segment surgery. Further prospective studies are required to evaluate reproducibility, learning curve, and potential benefits on surgical precision and outcomes.