Launched in March 2025, the METIS 900 microscope is quickly gaining acceptance as the go-to, high-quality “surgical control center” for surgeons seeking to incorporate state-of-the-art technology into their routine practice.
The addition of the METIS 3D Digital Heads-Up Module (METIS HU) – an integrated digital 3D visualization platform created to solve daily ergonomic challenges – has further cemented the platform’s reputation. The upgrade follows clinician feedback on ergonomic issues in existing ophthalmic microscope platforms, as well as the need for higher image resolution and advanced digital processing capabilities.
Further, Haag-Streit is set to enhance the platform by closing the biometry-to-OR workflow loop with an interoperative toric alignment system, due for global release in 2027.
The platform has already been well received in clinical practice. One of the first surgeons in the world to use METIS 900, Dr. Yuri McKee, Medical Director & Managing Partner at East Valley Ophthalmology, Arizona, observes that “the controls were familiar and yet there are so many more options to adjust the microscope in surgery.”
Another early proponent of the platform, Dr. Kenichiro Yamazaki, Founder and Chief Surgeon of the Omiya Nanasato Eye Institute (ONEI), Japan, says that the METIS 900 optimized both clarity and surgical precision, noting that the “brilliant red reflex provides the optical clarity and brightness required for my procedures.”
As the most experienced surgeon of laser-assisted cataract surgery working in Japan today, Dr. Yamazaki adds: “For the surgeon, there is an inherent conflict when it comes to microscope illumination. Higher illumination is preferable for visualizing fine structures, yet excessive brightness causes reflections from fragmented lens material during phacoemulsification, making it harder to see. With the METIS 900, fine structures remain clearly visible even at low illumination, effectively resolving this conflict.”
METIS HU “surgical cockpit”
METIS HU has bolstered METIS 900’s existing capabilities – high-quality optics, coaxial red reflex, and motorized positioning – by turning the platform into a more immersive digital “surgical cockpit,” without compromising any of its conventional microscope functionality.
METIS HU introduces a 3D stereo 4K camera and 55- inch OLED 3D 4K monitor to replace eyepiece viewing with a large heads-up surgical image and offers even greater depth-of-field and adaptive imaging. Combined, this technology helps surgeons see and manipulate delicate anterior- and posterior-segment structures more clearly.
Dr. Christopher Riemann, Vitreo-retinal Fellowship Director, Cincinnati Eye Institute, commented: “The resolution is superb and the unique feature of being able to actively adjust the camera settings intraoperatively provides a level of control that surgeons will love. We can’t fix what we can’t see, [but] with METIS HU we can see beautifully.”
Dr. Edward Meier, Director of Apex Eye Clinical Research in Cincinnati, Ohio, explained: “The METIS HU has wonderful image clarity that is as good as a regular light path microscope. One of the best things is that you can use digital illumination to brighten the image while using a much dimmer microscope light. This is much more comfortable for the patient while still delivering an excellent view and red reflex.”
Dr. Yamazaki also points to the benefits of the digital illumination provided by METIS HU: “I can operate effectively at just 20% illumination, which still provides clear visibility while reducing light exposure for patients. Even at low illumination levels, it delivers bright, high-quality video recordings suitable for clinical documentation and presentations.”
Improved ergonomics alleviate neck & back strain
METIS HU’s improved ergonomics are also praised for creating a true heads-up posture to alleviate neck and back strain during long procedures, reducing head tilting and allowing surgeons to maintain a neutral, upright position. “At the end of a long day, my neck and back are much less tired than when using a traditional microscope,” notes Dr. Meier.
Dr. McKee underlines how Haag-Streit has built its optics and scopes around ergonomics, “prolonging surgeons’ health and longevity in their careers.”
“Every surgeon should be able to set this microscope [to] exactly what’s correct for them in surgery so that their spine is straight, their neck is straight, and they’re looking straight ahead,” he continues.
“Avoiding neck and back problems goes beyond the operating room. You want to go home, see your kids, see your wife, live an active life. And you can’t do that with a messed-up neck or a messed-up back.”
Teaching & collaboration
METIS HU also focuses on improving the teaching and collaborative capabilities of the existing system: its large 55-inch OLED 3D 4K monitor, fed by its 3D stereo 4K camera, displays the surgeon’s stereoscopic operative view live, meaning that everyone in the operating room can share the surgeon’s 3D view in realtime, as well as allowing additional 3D monitors to be linked for teaching or remote observation.
“In my clinic, staff provide real-time explanations to the patient’s family while displaying the surgical view from the microscope on a monitor during the procedure,” explains Dr. Yamazaki. In addition to helping family members gain a greater understanding of what is happening during surgery, Dr. Yamazaki says this new benefit also allows him to review his own cases afterward.
“The exceptional clarity and fine detail captured in the recordings make it easier to identify subtle findings and areas for refinement,” he adds, “which I find invaluable for improving my surgical technique on an ongoing basis.”
Guiding light
Currently under development, IOL Guide – Haag-Streit’s toric lens alignment guidance system for premium cataract lens surgery – will connect and transfer biometry data directly into the METIS 900 microscope to create a digital workflow for the OR.
Developed as a seamless extension of the Haag-Streit Lenstar 900 and Eyestar 900, the IOL Guide supports surgeons at every single step of IOL implantation. Using Haag-Streit’s patented EyeSuite IOL calculation and planning software, predetermined parameters – including incision locations, capsulorhexis diameter, and the axis of the toric IOL relative to the eye’s position – can be overlaid either in the eyepiece or directly onto a connected monitor, allowing surgeons to access precise, accurate details of the implantation steps. Additionally, by enabling direct data transfer to the METIS via USB or network, the system is intended to minimize both duplication of data and effort.
“Haag-Streit has demonstrated over the years that they’re absolutely devoted to improving their products [and] they won’t release something until it’s ready to be released,” says Dr. McKee. “Absolutely everything from the design to the manufacturer to the delivery of a Haag-Streit microscope is second to none, and I think surgeons already know that based on their use of Haag-Streit slit lamps.”
Health & prosperity
Emphasizing the importance of upgrading rather than simply replacing existing equipment, Dr. McKee adds: “We really need to start thinking about the microscope as a platform just like we think about so many other things that we use, like our phones and even now our cars. These platforms can be expanded in the future because they’re digital with enormous technology. [With METIS 900] we’ve started with the rock-solid quality of a Haag-Streit microscope, and now we can expand this platform without buying a new microscope every five years.”
This is exactly what Haag-Streit is achieving with the METIS platform. Building on the company’s long-standing reputation in the industry, it has created a long-lasting, high-quality surgical control center that doesn’t have to be replaced at regular intervals with the “next best thing.” Instead, METIS 900 – together with METIS HU and the upcoming IOL Guide – represents an altogether different prospect: an integrated system aimed at sustaining surgeons’ long-term professional careers without having to sacrifice their quality of life in the process.
