TrueVision Adds Alcon as Digital Microscope Partner

TrueVision Systems’ 3D Digital Microscope Platform recently received a boost thanks to a partnership agreement with Alcon penned just before OIS@ASRS, TrueVision CEO Forrest Fleming reported during the “Retina Company Showcase.”

Fleming outlined four benefits of TrueVision’s digital platform, called NGenuity, compared with traditional ocular devices: higher depth of focus and working distance at the retina surface in high magnification; high dynamic range imaging that reduces the instrument glare and illuminates shadows; digital image filtering that gives different color effects – for example, red-free mode when blood is present in the surgical field; and reduced light levels to avoid the likelihood of light toxicity.

The ability of the surgeon to view the eyepiece without bending over is also significant, Fleming said. “Ergonomically, this poses a difficult challenge for many surgeons,” he explained, noting that many ophthalmic surgeons have chronic head and back problems from years of bending over to view surgical microscopes.

The current iteration represents the fifth-generation device, Fleming said. Some 300 are in clinics where surgeons have performed more than 15,000 head-up operations with them, he stated.


Forrest Fleming

Forrest Fleming

FORREST FLEMING, CHIEF EXECUTIVE OFFICER AND BOARD MEMBER Has been the CEO of True Vision since 2006. He has a distinguished track record of creating successful start-up companies across a diverse industry portfolio, specializing in creating, funding, and executing business plans to optimally commercialize world-changing inventions.

View Full Profile


Forrest Fleming: Thank you to the OIS committee for letting me speak today on a topic that I think is compelling and will be helpful for retina surgeons. I’m going to introduce a topic that we call digitally assisted vitreoretinal surgery. All right? In retinal surgery today, this is the – a typical day in the office for a retinal surgeon. The optical microscope is the standard of care for visualization. Universally, we hear that surgeons would like to see more and see better. That’s one of the issues. Also, ergonomically, this proposes a pretty difficult challenge for many surgeons. It’s pretty well documented that over 50% of retinal surgeons have neck and back problems at the time of 50. We think we can transform that paradigm to this picture that you see. Heads up surgery here being performed by Dr. Pravin Dugel in his Phoenix OR. Interesting to note that Pravin tried this modality of surgery and from case 1, immediately preferred it and has never gone back to the oculars. The digital revolution is happening in every aspect of our lives. If you look at everywhere digitization is occurring, for the same reasons that it’s occurring everywhere, it will happen, in my opinion in surgical visualization. It’s what we provide at TrueVision is a bridge between that optical paradigm to the digital one. And this enables many, many important surgical technologies today, including robotics, computer guidance, overlay of information, telemedicine, etc. And the reason for this is simple. The digital images can be integrated, enhanced, and transmitted in a way that optical images cannot. It is a complicated process. We have found that this has taken us quite a bit of time to get to image parity with the microscope. The microscope companies are very good at what they do; they’ve been perfecting their optics for 50 years. So this was a big challenge for us. But at this point in time, we think that with our fifth generation, we have achieved parity and we’re ready for prime time. How did we get here? Ten years, 18 patents, 300 customers, 15,000 heads up surgery. This is what we’ve done to get to this point we’ve arrived today with those achievements. How do we get to market? We choose world class partnerships. Our first partner was Leica Microsystems. I see Heinrich [Drier?] in the audience. Thank you, Heinrich for trusting and believing in the digital paradigm. We also here today want to announce our new partnership with Alcon. Very, very excited about this. I want to thank Paul Hallan, Mike Lonisczek for helping to see this vision. Today we are announcing a product, Ingenuity, which is technology by TrueVision delivered by Alcon, available today at ASRS. I would like to share with you a video that talks a little bit about surgeons’ perspectives.

This is the best thing that’s happened to retinal surgery because visualization has lagged behind all the other improvements in technology.

One of the things that I really liked about this system was the amazingly good view that you were able to achieve with their 3D technology. The depth of field was excellent; the clarity was great. Found that I could work with a lower illumination power.

Just the ability to maintain depth of field under high magnification and still have a relatively wide field of view.

Digital visualization and digital platform, because it’s going to be more than visualization. It’s going also impact our therapies and the way we manipulate tissue. The easier it is for the surgeon, the better we can do for our patients.

Forrest Fleming: So Enginuity offers many benefits, and I can’t go into all of them, but I want to highlight four. I talked to Steve Charles, and he thought that the first and most important benefit would be that Enginuity creates a higher depth of focus and essentially a higher working distance at the retina surface in high magnification. It also creates high dynamic range imaging, which allows the surgeon to reduce glare of instruments and also see into the shadows. It also uses digital image filtering, which can give different color effects. For example, if there’s blood present in the surgical condition, you can operate reds-free so you can see the vitreous better. And finally, you have reduced light levels, over 50%, that can improve the light toxicity to both patient and surgeon. These are some of the benefits. Also, ergonomically it’s far superior. And perhaps most importantly, it’s going to be a platform that continues to grow and enhance and change. So Enginuity is here today. The digital revolution continues, so only one question remains. Are you ready? Thank you.