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The Pipeline | Sept/Oct '14


The era of digital cataract surgery is upon us. New technologies have focused on using digital tools to integrate the preoperative planning phases of cataract surgery into the intraoperative setting, assisting in the positioning of toric and multifocal IOLs. Cirle, a medical technology incubator based in Miami, Florida, has been building capabilities and expertise in surgical navigation to deliver advanced solutions for physicians. With its unveiling at the 2014 American Society of Cataract and Refractive Surgery (ASCRS) meeting in Boston, Cirle announced a licensing agreement with Bausch + Lomb for its Surgical Navigation System (SNS). The Cirle SNS is an integrated surgical guidance tool designed to provide surgeons with three-dimensional (3-D) imaging in their microscope, helping guide them through the stages of cataract surgery, such as in incision placement, capsulotomy, IOL alignment, and limbal relaxing incision placement. Cirle is bringing us features in digital surgery, including the display of 3-D marks on anatomic features, eye tracking technology, and seamless integration of one’s operating room components.


Richard M. Awdeh, MD, of Bascom Palmer Eye Institute, established Cirle in 2010.

The Surgical Navigation Guidance Console has an easy-to-use interface that intelligently guides surgical planning, allowing the surgeon to view the patient’s data within his or her microscope. The design of the system creates 3-D images that highlight the anatomic layers that are most important to the execution of the steps of a procedure, a feature called holotagging. The console generates and displays corneal incisions at the corneal level, capsulotomy guides at the capsule level, lens alignment marks at the IOL level, and machine parameters at the limbal level.


The Microscope Interface Module component of the Cirle SNS contains a sophisticated optics system, designed to capture 3-D images of the eye through StereoCapture. This advanced technology displays the surgical plan that has been entered into the Surgical Navigation Guidance Console, along with the Stellaris’ (Bausch + Lomb) system information, all through a 3-D perspective within the microscope.


Richard M. Awdeh, MD, of Bascom Palmer Eye Institute, established Cirle in 2010.

The system has been designed to work with the physician’s microscope, preferred IOL, and surgical technique. This technology is intended to be a platform for future applications, yet be versatile enough to integrate with existing operating room offerings. Although the SNS is still undergoing production and commercialization, expected outcomes include improved accuracy of toric IOL alignment, corneal and arcuate incision placement, and capsulorhexis creation as well as overall improvements of the doctor’s surgical experience.

In addition to the SNS, Cirle is leveraging its resources to develop a robust pipeline of medical devices and products. Established in 2010 by Richard M. Awdeh, MD, of Bascom Palmer Eye Institute, Cirle is focused on curing diseases that lead to blindness through the use of translational medical research and innovative technologies. The company, which entered a relationship with Bascom Palmer in 2011, develops and acquires early-stage technologies, applies its specialized capabilities to refine and test them, and pursues industry collaborations to rapidly bring them to market. Offering a highly interactive environment for interdisciplinary innovation, Cirle has engaged leading eye health experts, engineers, and researchers who are involved in development projects.

John Berdahl, MD

John Berdahl, MD, is an Assistant Professor of Ophthalmology at the University of South Dakota and in practice at Vance Thompson Vision in Sioux Falls, South Dakota. He may be reached at john.berdahl@vancethompsonvision.com.