Sean Ianchulev, MD, MPH, Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai and Director of Ophthalmic Innovation and Technology at New York Eye and Ear Infirmary of Mount Sinai (NYEE), will introduce a new surgical technology for real-time measurement of eye fluid dynamics during surgery, according to an April 9 announcement. The device, called miDOC (micro-interventional Dynamic Outflow Curve), is set to be presented during the Charles D. Kelman Innovator’s Lecture at the American Society of Cataract and Refractive Surgery annual meeting in Washington, D.C., on Sunday, April 12.
The development is significant because it offers surgeons a way to monitor critical intraoperative parameters—such as ocular flow and pressure—that have been difficult to assess during eye surgeries like glaucoma procedures. This could lead to more precise surgeries and better outcomes for patients undergoing these interventions.
miDOC was developed by Dr. Ianchulev at NYEE with support from Mount Sinai Innovation Partners. It provides continuous intraoperative measurement so that surgeons can adjust their approach in real time based on each patient’s needs. NYEE is currently the only center using this technology in clinical studies; since July 2025, they have completed the first 20 patient cases with successful intraoperative biometric guidance.
Gautam Kamthan, MD, Assistant Clinical Professor of Ophthalmology at Icahn School of Medicine and Assistant Director of Ophthalmic Innovation and Technology at NYEE—who co-invented miDOC—said: “Intraoperative measurement of aqueous outflow has not previously been possible during ophthalmic surgery. This capability has the potential to transform outflow-based surgical interventions by advancing the field toward high-precision biometry and improved clinical outcomes.”
Current glaucoma surgeries lack real-time monitoring capabilities; surgeons typically check intraocular pressure only before or after procedures, which can result in unpredictable outcomes. More than half of patients undergoing certain glaucoma operations do not achieve complete postoperative success or medication independence until follow-up appointments reveal complications or failures—a contrast with cataract surgery where accurate biometry yields highly predictable results.
While miDOC was initially designed for glaucoma surgery, researchers believe it may benefit other ophthalmic procedures as well—including cataract operations where postoperative spikes in eye pressure can threaten vision. Early use suggests miDOC might also detect choroidal blood flow important for retinal health—and potentially provide insights into broader physiological systems such as cerebrovascular or cardiac function.
The device remains investigational pending U.S. Food and Drug Administration clearance; further refinement is planned along with pursuit of regulatory approval for wider use. Drs. Ianchulev and Kamthan are named co-inventors on a patent filed through Mount Sinai—the technology remains unlicensed but could bring financial benefits if commercialized.
