Advances in ophthalmic surgery depend not only on the skill of the surgeon but also on the quality of the instruments that enable precision, versatility, and comfort. For more than a century, Haag-Streit has been synonymous with optical excellence. Their newest innovation – the METIS 900 ophthalmic microscope system – represents a culmination of design, ergonomics, and forward-looking digital capability.
Dr. Yuri McKee, Medical Director and Managing Partner at East Valley Outpatient Surgery in Mesa, Arizona, and Partner Surgeon at East Valley Ophthalmology, is the first surgeon in the world to use the METIS microscope in human surgery. Here he outlines why METIS represents not just an incremental improvement, but a whole new surgical platform.
Stable and brilliant red reflex
METIS was engineered to deliver a stable, bright, homogenous red reflex with optimized coaxial illumination. This is vital in cataract procedures, where visibility in a confined intraocular space depends on consistent lighting. The “amazing red reflex is very stable on METIS,” notes Dr. McKee. “It’s the product of three different illumination sources. Two are coaxial and one is tangential, and this allows a lower luminosity inside the eye to reduce light toxicity to the retina. It also allows for that red reflex to be stable across a variety of surgical maneuvers and eye positions.”
Noting the microscope’s integrated depth-of-field adjustment and world-renowned Haag-Streit optics – with high-definition 4K visualization providing superb color, clarity, and crispness – Dr. McKee explains, “Cataract surgery is the most important procedure to take advantage of a red reflex. We’re working inside the eye in a very limited space. We need depth of field at certain points, we need more detail at other points, and we need a strong red reflex to maintain a high level of detail throughout the entire surgery.”
He adds, “We’re casting shadows within the red reflex that show three-dimensionality. So when you see the videos of a simple capsulorhexis, you’re going to see this rhexis in ways you’ve never seen before. As we advance through the surgery, the eye moves around a little bit, but we don’t lose our red reflex through hydrodissection or phacoemulsification because of the dual light source.
Ergonomics and surgeon well-being
The METIS system’s ergonomics deliver a comfortable working experience. The binoculars are brought forward, allowing surgeons to adopt good posture, relieving pressure on the neck, back, and spine. This, plus motorized tilting and a smart design to maximize the surgeon’s working space, ensures freedom of movement all day long.
“Haag-Streit has a strong dedication to ergonomics and to maintaining th surgeon’s health and career longevity,” says Dr. McKee. “We have fewer and fewer eye surgeons coming into the field and more eye surgeons retiring prematurely, often for the sake of their physical health, especially their spine. But every surgeon should be able to set METIS to exactly the right position for them, so that their spine is straight, their neck is straight, and they’re looking straight ahead during surgery.”
Digital platform and presets
One of the defining qualities of METIS is its adaptability as a digital plaform. “We really need to start thinking about the microscope as a platform, just like we think about so many other things, like our phones, and now even our cars,” says Dr. McKee. As a digital platform, METIS can be programmed with presets, making it “completely customizable.” The programmable foot and hand switches allow the surgeon to effortlessly tilt, filter, focus, and zoom. “For me, one of the most important examples of these presets is the motorized glaucoma tilt function,” says Dr. McKee. “Instead of asking the nurse to try and set the microscope to my desired angle, I can preset the angle with the touch of a button. The tilt function will move the microscope to exactly the angle I want for MIGS surgery. And when I’ve completed the MIGS portion of the surgery, another touch of a button brings it back to its normal operating position.”
Workflow efficiency and recording
The METIS 900 Microscope Imaging & Operation System (MIOS) features interactive menus to guide your team effortlessly through the surgical workflow, allowing customizable profiles, recording, and system management via a touchscreen dashboard. “One of the really cool functions, as I grab the microscope and bring it onto the field, is that the recording can be programmed to start automatically,” says Dr. McKee. “There’s no more forgetting to push the record button, and especially when something interesting happens in surgery.”
LED illumination: efficiency and longevity
The METIS includes the most efficient light source available, LED, which emits less heat and consumes significantly less energy than traditional xenon or halogen equivalents – providing all the benefits of brilliant illumination while being more environmentally friendly. “The METIS’ LED is not an afterthought,” observes Dr. McKee. “A lot of effort went into making a high-quality, long-lasting LED with a very high color rendering index (CRI). This gives you better imaging during surgery and colors that you didn’t know existed when you were operating with older microscopes.” He adds, “My LED lights have thousands of hours on them. They should not need to be changed – they are designed to last the lifetime of the microscope.”
The Haag-Streit promise
“Haag-Streit has demonstrated to me over the years that they’re absolutely devoted to improving their products,” Dr. McKee continues. With the METIS 900, “there’s no question about the quality of the optics, the build, and the image that we see through the microscope. Absolutely everything from the design to the manufacture to the delivery of the microscope is second to none.” Importantly, the METIS 900 is also “future-proof.” Dr. McKee explains, “There are so many great ideas that will be incorporated into this microscope over the next several years; that’s the real beauty of it. We’re starting with a Haag-Streit microscope of rock-solid quality, and then the platform will continue to be expanded and updated – without the surgeon needing to buy a new microscope every five years.”
Dr. McKee’s real-world insights tell the story of a microscope that is optically superior; ergonomically designed; digitally adaptable; workflow-oriented; and sustainably built. As he concludes, once surgeons experience the features and benefits of the METIS 900, they’ll “never want to go back.”
Watch the full Dr. Yuri McKee METIS 900 testimonial video below
