Tuesday, September 22, 2009

Endoscopy in Ophthalmology: The Latest News and Some History

I saw a brief writeup in the current OSN Supersite (September 22, 2009) about Endo Optiks launching a new series of high-resolution micro-endoscopes and it brought to mind the first time I learned and wrote about this company.

I first learned about video endoscopic techniques being used in ophthalmology in the Spring of 1991. At that year’s ASCRS Meeting I learned about Summit Technology’s OmniView and at the Fall AAO Meeting, about Escalon’s InnerView.. In the Summer of 1992, I learned about the newest technology in this field, to be introduced at that Fall’s AAO Meeting, the MicroProbe video endoscope from Endo Optiks. The story about these endoscopes was published in the October 15, 1992 issue of Ocular Surgery News.

I thought that some of you might be interested in both the latest news and a little bit of history.

Here is the latest news from Endo Optiks, followed by the original writeup published in October 1992.

Endo Optiks launches series of high-resolution micro-endoscopes

LITTLE SILVER, N.J. — Endo Optiks has added a new series of high-resolution micro-endoscopes to its existing endoscopes line, providing improved image quality and increased field of view, according to a press release from the company.

"We designed the new high-resolution scopes to help surgeons better visualize the anatomy of the eye," Martin Uram, MD, endoscope creator and co-founder of Endo Optiks, said in the release. "Surgeons will find improved visualization when performing endoscopic cyclophotocoagulation, panretinal photocoagulation and diagnostics."

Two new versions have been launched: the Triple Function Micro-Endoscope and the Dual Function Micro-Endoscope. Both combine light and imaging, but the Triple Function Micro-Endoscope model also offers laser, the release said. The Triple Function Micro-Endoscope has a 19-gauge probe, while the Dual Function Micro-Endoscope has a 20-gauge probe.

The high resolution of the devices is a 70% increase in pixels from the company's existing scopes, from the current 10,000 pixels to a 17,000 pixel fiber optic bundle, the release said.

In addition, the devices offer an expanded 160̊ field-of-view.

Source: OSN SuperSite 9/22/09

Original writeup as submitted July 17, 1992 to Ocular Surgery News and published in the October 15, 1992 issue:

Technology Update


Irving J. Arons
Ophthalmic Consulting Group
Arthur D. Little

It was inevitable that video endoscopic techniques, now widely practiced in general laparoscopic/endoscopic surgery, should finally reach ophthalmology. True, most inner parts of the eye are readily viewed through the pupil and minimally invasive surgery has been a part of the ophthalmologist's armamentarium for some time, but certain parts of the eye are not easily viewed, much less treated, and this new technology seeks to correct this oversight. With the new technology, eye structures such as the back of the iris, the ciliary body, the far reaches of the retina, and sites at or near the zonule attachment points can now be clearly seen and treated. Further, with the magnification and visual detail available with today's video endoscopic equipment, enhanced views of cellular level structures are now possible for other areas of the eye as well.

Over the past two years, at least two video endoscopic techniques have been introduced into ophthalmology. At the 1991 ASCRS meeting, Summit Technology announced its OmniView, an ophthalmic fiberendoscopic system containing between 50 to 70 illuminating fibers surrounding an image guide, all bundled into an 0.8 mm probe. It was introduced for viewing of sutures placed into the ciliary body, for inspection of the integrity of the posterior capsule, and to verify IOL haptic placement. Other applications suggested were for viewing retinal and glaucoma surgery, for otolaryngology, lacrimal duct surgery and for neurosurgery. Summit expected to sell the system for about $18,000.

The second ophthalmic endoscopic system was InnerView, launched by Escalon Ophthalmics at last fall's AAO meeting. This again is a small (20 gauge, 0.9 mm) flexible endoscope probe that can be coupled to a high resolution video display. Although the price had not been fixed at the time of introduction last fall, it was estimated that the system would sell for between $16,000 to $18,000 complete.

However, the newest endoscopic technology, to be launched at this fall's Academy Meeting, is the MicroProbe, an integrated diode laser treatment device combined with a high resolution microendoscope. The new device is from Endo Optiks, a two-year old Little Silver, NJ startup company, founded by Dr Martin Uram, a retinal surgeon in New Jersey. Endo Optiks has been able to couple an endoscopic viewing system with a diode laser and is working on incorporation of an aspirator system, all into a 20 gauge (0.89 mm) probe that can both view and treat formerly inaccessible parts of the eye. Further, with its high resolution color capabilities, the system can be used for diagnosis of difficult to view intraocular structures.

The heart of the system is a unique, patented, lens delivery system that combines a high illumination light source, a high resolution video endoscopic pickup, and a 0.1 to 2 watt 810 nm diode laser photocoagulation delivery system, all contained within a 20 gauge probe. This will allow the surgeon to view and treat a variety of eye structures including the peripheral retina, the pars plana, ciliary body and the posterior aspects of the iris in vivo.

The MicroProbe consists of a compact console containing the light source, the high resolution video monitor, a VCR recorder, the aspirator pump, the diode laser (including a red diode aiming beam), and simple keyboard controls. The system has been undergoing clinical evaluation trials, has received 510 (k) marketing clearance, and will be officially launched at this years AAO Meeting (1992) in Dallas.

By integrating the viewing and treating modalities into a 20 guage handpiece, the new system is truly a breakthrough in ophthalmology. In addition to viewing and treating the peripheral retina and ciliary processes, the unique system can be used for up close and personal diagnoses of other eye structures, giving high resolution colored views of the retina, lens, iris, and other ocular structures (and implants).

The primary application for the new device is expected to be for retinal surgeons for performing all types of vitreoretinal procedures. However, it is expected that glaucoma specialists will also find use for the device in pursuing direct visualization and laser treatment of the ciliary processes, as an alternative treatment for intractable glaucoma. The technology holds great promise for use in other medical fields as well. It is anticipated that the MicroProbe integrated endoscopy and laser system will sell for between $50,000 to $60,000 when it comes to market this fall.


At 5:00 AM, Anonymous Video Capsule Endoscopy said...

Really a great post on Endoscopy in Ophthalmology: The Latest News and Some History.


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