What You Should Know
- The Technology: A team at Mount Sinai has developed miDOC (micro-interventional Dynamic Outflow Curve), a novel surgical technology designed to continuously measure critical fluid dynamics inside the eye during surgery.
- The Solution: miDOC provides real-time, intraoperative measurements of pressure, flow, outflow facility, and ocular compliance. This allows the surgeon to dynamically adjust the procedure based on the patient’s immediate physiological response.
How Mount Sinai’s miDOC Brings Real-Time Biometrics to the OR
In the world of ophthalmology, there is a massive disparity in surgical predictability. Today, ff you go in for cataract surgery, the outcome is incredibly precise. Thanks to advanced optical biometry, 95% of patients achieve a highly successful refractive outcome. But if you go in for glaucoma surgery, the odds drop dramatically. More than half of all patients undergoing trabeculectomy and drainage device implants fail to achieve complete postoperative success.
The reason for this failure rate isn’t a lack of surgical skill; it is a lack of real-time data. Glaucoma surgeons operate “blind” to the exact ocular flow and pressure happening inside the eye during the actual procedure. They make their surgical interventions and then have to wait until a follow-up appointment to see if the pressure actually stabilized.
Today, researchers at Mount Sinai announced a technological breakthrough designed to finally close this data gap. Dr. Sean Ianchulev, Director of Ophthalmic Innovation and Technology at the New York Eye and Ear Infirmary of Mount Sinai (NYEE), is unveiling miDOC (micro-interventional Dynamic Outflow Curve). Developed alongside co-inventor Dr. Gautam Kamthan, the device provides continuous, real-time intraoperative measurement of ocular flow and pressure.
“This is the equivalent of what optical biometry did for cataract surgery. miDOC brings precision to glaucoma surgery that simply has not existed before,” said Dr. Ianchulev.
The Real-Time Feedback Loop
During the first 20 in-human cases conducted at NYEE, miDOC fed surgeons continuous data on pressure, flow, outflow facility, and ocular rigidity. Instead of guessing how an incision or a drainage implant was affecting the eye, the surgeon could watch the physiological metrics change in real time and adjust their technique on the spot.
“Intraoperative measurement of aqueous outflow has not previously been possible during ophthalmic surgery,” noted Dr. Kamthan. “This capability has the potential to transform outflow-based surgical interventions.”
miDOC Clinical Status
The device is currently investigational and not yet FDA-cleared. However, the New York Eye and Ear Infirmary of Mount Sinai (NYEE) has successfully completed the first 20 first-in-human cases using the tech since July 2025.
Future Applications in Cataract surgery
Cataract surgery is the most common surgical procedure in the world. While generally safe, some patients experience dangerous, vision-threatening intraocular pressure spikes in the immediate recovery period. Utilizing miDOC during these routine procedures could allow surgeons to proactively identify at-risk patients before they ever leave the operating table.
Furthermore, investigators are already exploring how the device can detect choroidal blood flow, which could provide early warnings for complex chorioretinal diseases.
Dr. Sean Ianchulev will officially unveil the technology during the prestigious Charles D. Kelman Innovator’s Lecture at the ASCRS annual meeting on April 12.
