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ASCRS DIGITAL CLINICAL COMMITTEE SYMPOSIA AT THE 2025 ASCRS ANNUAL MEETING continued from previous page to raise the patient's chair up so you can slide your stool under the chair. She also said it's important to maintain good posture, with your head over your shoulders and your shoulders back. Another big issue is the indirect ophthalmoscope. She suggested simply raising the patient's chair all the way up. Sitting down can also cause a lot of issue, she said, noting that sitting puts 250 times more pressure on discs compared to lying down. Even standing is better, as it only puts 100 times more pressure on discs. If you're sitting, take note of the ideal sitting posture; you want to ensure you have good lumbar support. Dealing with the issue of the operating microscope, you can tilt the microscope, and heads-up digital technology can be helpful. She encouraged physicians to take microbreaks to stretch. Steps for transitioning to digital Inder Paul Singh, MD, shared some steps for transitioning to digital options. He mentioned that he had neck surgery and transitioned to using heads-up technology in his OR. The key to transitioning is making sure you have a good room set up, he said, suggesting that you not move the monitor for every case. Instead, move the bed. Another important transition has been surgeon posi- tioning, he said. It's important to look at neck position. The key is not to have to sit across from your oculars; sit across from the screen to keep your neck in the optimal natural position. "For me as a glaucoma surgeon, it's wonderful not to have to adjust my neck when I tilt the patient's head and the scope," he said. Dr. Singh noted that you can still use the oculars, if needed. There's a mode on the scope he uses where you can choose to use oculars, a hybrid mode with oculars and screen, and a mode with the screen alone. While he uses the Zeiss heads-up option, he noted that there are other heads-up displays, such as those from Alcon, Bausch + Lomb, and the Beyeonics headset. Each has their unique attributes. While Dr. Singh recommended trying not to go back and forth between the digital option, he said it's possible to im- plement it in steps if that's easier. Give yourself a couple of surgical OR days to develop muscle memory. If you go back and forth too much, you never feel comfortable, he said. When transitioning to digital, it's also important to involve your staff. "What 3D heads-up has done is allowed my staff to be more proactive," he said. "They can see what we're seeing and can anticipate better." Finally, Dr. Singh noted the training benefits of heads- up technology. It's great to have the audience watching and seeing exactly what you're seeing, he said. He went on to discuss the Zeiss AI formula. The ap- proach was to construct it with 500,000 ray tracing models. They tried to train it to predict postop IOL position using real-time preop biometry and real postop ACD, then refined it with real-time preop biometry and actual postop spherical equivalence. There are no IOL constants; these are opti- mized for each unique IOL model. Discussing surgical video analysis, Dr. Weikert noted the functionality of uploading surgical videos to the cloud with the click of a button. The Zeiss surgery dashboard is user friendly, and you can upload videos in one tap, he said. Surgery details are matched with videos, and AI efficiently measures surgery steps and compares videos side by side. You can learn from experienced surgeons around the globe and benchmark yourself against a curated selection of ref- erence cases. AI labels, segments, and arranges surgeries on the cloud, providing easy access, he added. Finally, with preoperative macular OCT analysis, we know for premium IOLs that we want pristine eyes and to avoid macular pathology. He noted the CIRRUS Pathfinder, which is trained by retina specialists with 75,000 B-scans and has 88% sensitivity and 93% specificity. It can auto- matically screen patients preoperatively and assist in lens selection and determine correct referral paths. It is not yet available in the U.S. 'Digital Visualization in Eye Surgery – Is It Time to Adopt?' The second symposium from the ASCRS Digital Clinical Committee was designed to help demystify technology for visualization in surgery, helping physicians decide what might be appropriate for their practices and when. It was sponsored by Alcon and Zeiss. Ergonomic considerations in ophthalmology Kicking of the session, Deepinder Dhaliwal, MD, said ergo- nomics is a personal passion project of hers. She had a disc herniation in her back after she fell in the operating room, which caused severe back pain radiating down her right leg associated with right leg weakness. It was recommended that she undergo microdiscectomy, but Dr. Dhaliwal used daily physical therapy, acupuncture, and meditation. She said that she is 85% recovered with this conservative therapy. Now, she thinks about ergonomics and posture every day. Musculoskeletal disorders are a problem in the ophthal- mology profession. Using ergonomically designed furniture can help protect the body from injury. The slit lamp, for example, is one of the worst problems because the surgeon is often craning their neck. You need

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