Mmount Sinai Ophthalmologist Unveils Breakthrough Ocular Fluid Monitoring Tool

A Mount Sinai ophthalmologist will unveil a caller surgical exertion that allows oculus surgeons to measurement and respond to captious fluid dynamics wrong nan oculus successful existent time—an beforehand that whitethorn importantly amended precision and outcomes successful glaucoma and different ophthalmic procedures. 

The technology, called miDOC (micro-interventional Dynamic Outflow Curve), will beryllium introduced by Sean Ianchulev, MD, MPH, Professor of Ophthalmology astatine nan Icahn School of Medicine astatine Mount Sinai and Director of Ophthalmic Innovation and Technology astatine New York Eye and Ear Infirmary of Mount Sinai (NYEE), during nan prestigious Charles D. Kelman Innovator’s Lecture astatine nan American Society of Cataract and Refractive Surgery (ASCRS) yearly gathering successful Washington, D.C., connected Sunday, April 12. The speech is designed to item visionary leaders successful cataract and refractive room and observe their contributions to nan field.  

Developed by Dr. Ianchulev at NYEE with funding from Mount Sinai Innovation Partners, miDOC is designed to supply continuous intraoperative measurement of ocular travel and pressure—parameters that person historically been difficult to measure during surgery. The strategy enables surgeons to monitor changes successful existent clip and set procedures accordingly for each patient. 

This is nan balanced of what optical biometry did for cataract surgery. miDOC brings precision to glaucoma room that simply has not existed before. We are surely connected nan verge of something very exciting—bringing glaucoma room into nan property of digital-guided precision, precocious fidelity, and biometric feedback. This will allow glaucoma surgeons to 1 time execute akin outcomes arsenic we see in cataract surgical interventions.”  

Dr. Sean Ianchulev, MD, MPH, Professor of Ophthalmology, Icahn School of Medicine, Mount Sinai

Early objective experience 

NYEE is nan only oculus halfway successful nan state to usage this exertion and behaviour the first-in-human objective study. Surgeons started using it in patients successful July 2025 and have completed the first 20 cases. According to investigators, each procedures were successfully completed pinch intraoperative biometric guidance. 

During surgery, miDOC enabled continuous measurement of cardinal parameters including: 

1. Pressure 
2. Flow 
3. Outflow facility 
4. Ocular rigidity/Compliance 

These measurements provide new penetration into really surgical interventions impact nan oculus successful existent time. 

Addressing a captious spread successful glaucoma surgery 

While performing glaucoma procedures without miDOC, surgeons person nary measurement of checking a patient’s nonstop ocular travel and pressure, a captious adaptable successful nan operating room. They tin only cheque intraocular unit earlier and aft nan procedure, which leaves outcomes unpredictable.  

This has held backmost nan precision of glaucoma surgery, where, currently, more than 50 percent of nan patients undergoing trabeculectomy and drainage instrumentality implants fail to achieve complete postoperative occurrence and medicine independence. In immoderate cases, it is not until nan follow-up appointment that ophthalmologists observe nan process whitethorn not person worked and/or has possible complications.  

This contrasts importantly to cataract surgery, where 95 percent of patients achieve a successful refractive outcome within 0.5D of emmetropia—a very small amount of refractive error—because accurate biometry is available and critical to these outcomes.   

“Intraoperative measurement of aqueous outflow has not antecedently been imaginable during ophthalmic surgery. This capacity has nan imaginable to toggle shape outflow-based surgical interventions by advancing nan section toward high-precision biometry and improved objective outcomes,” says Gautam Kamthan, MD, Assistant Clinical Professor of Ophthalmology astatine nan Icahn School of Medicine and Assistant Director of Ophthalmic Innovation and Technology astatine NYEE, who co-invented this exertion and is nan Principal Investigator of nan study.   

Potential applications crossed ophthalmology 

While initially developed for glaucoma surgery, miDOC may person broader applications crossed ophthalmic procedures. 

Despite nan awesome imaginable for successful refractive outcomes aft cataract surgery, imagination tin still beryllium jeopardized if a diligent has a dangerously precocious spike successful oculus unit during nan contiguous betterment period. Using nan miDOC for cataract surgery—the astir communal room successful nan world—could thief place these patients and forestall imperishable imagination damage. 

As surgeons astatine NYEE use miDOC in much procedures, they person discovered that it tin perchance observe choroidal humor flow – this is the high-volume vascular proviso to nan eye's uveal tract, providing basal oxygen and nutrients to nan outer retina, peculiarly nan macula which is responsible for sharp, detailed, and high-resolution cardinal vision. Understanding nan wellness of nan choroid could pass retinal surgeons astir potential chorioretinal diseases. 

Researchers are besides exploring whether nan strategy can provide additional insights into cerebrovascular, cardiac, and lymphatic physiology, which could person implications for the remainder of nan body. 

Future development 

Investigators astatine NYEE scheme to further refine nan exertion and prosecute regulatory pathways for broader objective use. The instrumentality is presently investigational and has not yet received clearance from nan U.S. Food and Drug Administration. 

*Dr. Sean Ianchulev and Dr. Gautam Kamthan are named co-inventors of nan exertion “Micro-interventional Dynamic Outflow Curve (miDOC).” A patent for this exertion was revenge done Mount Sinai and the technology is presently unlicensed. The inventors and Mount Sinai would financially benefit if this technology is approved and commercialized.