LED lighting system for VR surgery scoops EURETINA Innovation Award

A new approach to intraocular illumination for vitreoretinal surgery using light-emitting diode (LED) technology has won the EURETINA Science & Medicine Innovation Award 2015.

“Using LEDs as a light source in vitreoretinal surgery offers a lot of potential advantages,” said Dr Christian Lingenfelder of Alamedics GmbH & Co KG, Dornstadt, Germany, the team leader of the project. “LEDs are less harmful to the patient, more convenient for the surgeon, and they are smaller and cheaper compared to conventional illumination provided by Xenon light sources and optical fibres,” he said.

At an awards ceremony held during the 15th EURETINA Congress, Dr Lingenfelder received a cheque for €20,000 in recognition of the project’s potential to improve a fundamental and critically important component of vitreoretinal surgery.

Other shortlisted projects at the awards ceremony included automated image analysis tools for diabetic retinopathy, a reusable needle trocar cannula system, a device for temperature control during pars plana vitrectomy, an automated diabetic retinopathy screening tool, and an implantable drug release device for age-related macular degeneration.

Praising the high standard of the entries received, Prof Einar Stefansson, chairman of the judging panel, said that the winning project had been chosen by consensus.

Presenting the features of the white LED technology, Dr Lingenfelder said that it answers a very real market need. Currently available chandelier endoilluminators for pars plana vitrectomy consist of conventional optical fibres coupled to a light source, he explained. Although the light probes of these fibres provide wide emittance angles, it is still often not possible to illuminate the whole intraocular space via just one incision. Therefore, several light probes or additional handheld endoilluminators have to be used simultaneously or the lights have to be repositioned during surgery.

To improve on this, Dr Lingenfelder’s team has come up with an innovative approach using white LEDs for intraocular illumination.The light source is a white LED with a conical tip that allows stable fixation within an incision. The physical properties of these LEDs were determined and used for calculating the relevant irradiance to assess the risk of causing harm to the eye. The illumination of the intraocular space was investigated using porcine eyes.

The studies showed that the illumination of porcine eyes with the modified LEDs was bright and homogeneous. Measurements and subsequent calculations proved that the expected thermal load and photochemical hazard were very low for human eyes, said Dr Lingenfelder.

The new device promises a reduced number of incisions with a simplified handling and need to add handheld light sources only if minimal intensity oblique illumination is helpful together with the chandelier illumination.

All of this contributes to a significant reduction of phototoxicity risks, and additionally there is a chance of cost reduction because expensive xenon or mercury lamps are no longer necessary, he said. These expectations have to be verified by further studies on human eyes, with trials expected to start in the near future.

In terms of market potential, Dr Lingenfelder said that about 500,000 vitreoretinal surgeries are performed in Europe every year, which gives some indication of the potential turnover for such a device. The technology could also potentially be extended into other fields such as diagnostic applications for general practitioners or new examination techniques for certain types of cancer.