ArticleClinical ophthalmology (Auckland, N.Z.)2026
Apple Vision Pro as the Intended Primary Intraoperative Visualization Platform for Complete Cataract Surgery: A Prospective Single-Center Feasibility Study.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To evaluate the feasibility and early safety observations of Apple Vision Pro as the intended primary intraoperative visualization platform during cataract surgery. Patients and Methods: This prospective, single-center, single-arm feasibility study evaluated Apple Vision Pro integrated with a ZEISS ARTEVO 850 three-dimensional digital surgical microscope. Forty-five patients undergoing cataract surgery were enrolled. Apple Vision Pro was used as the intended primary visualization platform, with conventional microscope oculars and an ARTEVO 850 three-dimensional monitor available as backup. Primary endpoints were procedure completion without device-related conversion and device-related intraoperative complications. Secondary endpoints included surgeon-reported workload and usability, operating room staff experience, and postoperative visual outcomes. Results: Forty-four of 45 procedures (97.8%) were completed using Apple Vision Pro without device-related conversion. One procedure required conversion to backup visualization after a transient image interruption perceived as image freezing; no patient harm or surgical complication occurred. No device-related intraoperative surgical complications were observed, although the study was not powered to assess rare complications. Mean patient age was 70.6 ± 8.8 years, and mean operative time was 15.4 ± 4.9 minutes. Mean best-corrected visual acuity improved from 0.50 ± 0.40 logMAR preoperatively to 0.02 ± 0.07 logMAR at 1 month. Surgeons reported low perceived workload on the modified NASA Task Load Index, and operating room staff reported minimal workflow disruption. Conclusion: In this prospective single-center feasibility cohort, Apple Vision Pro enabled completion of most selected cataract procedures using the intended primary visualization pathway within a defined workflow with immediate backup visualization. These preliminary findings suggest that wireless, head-mounted stereoscopic visualization may be feasible in a specialized, backup-supported surgical environment and support further controlled evaluation. However, these data cannot guide universal routine practice or establish comparative safety, clinical advantage, ergonomic benefit, routine clinical suitability, cross-specialty applicability, or detection of rare complications.
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