A NEW CATEGORY IN CATARACT SURGERY
Background
Cataract surgery is one of the most commonly performed surgical procedures in the world, with the surgeon replacing the eye's clouded natural lens with an artificial intraocular lens (IOL). The precision of that replacement determines the patient's vision for the rest of their life. Historically, surgeons calculated IOL power and astigmatism correction from preoperative measurements, then waited for postoperative results to see if their plan worked.
WaveTec Vision Systems set out to change that. The ORange Intraoperative Wavefront Aberrometer, launched in 2009, was the first commercially available device that allowed surgeons to measure the refractive state of the eye in real time during cataract surgery. The microscope-mounted aberrometer delivered measurements in seconds, giving the surgeon the ability to adjust IOL selection, alignment, and astigmatism correction while the patient was still on the table.
Areteworks was brought in to design the user experience for this first-in-class device, working across the microscope-mounted hardware, the footswitch-controlled measurement workflow, and the real-time display the surgeon would rely on under sterile field conditions.
UX FOR THE PERFUSIONIST'S WORKSTATION
Challenge
Designing UX for a product category that does not yet exist is a different problem than improving an existing device. There were no precedents to follow, no user expectations to meet, and no established mental model surgeons could draw on to interpret what the device was showing them. Every interaction had to be designed from observation of how cataract surgeons actually worked, then introduced in a way that would feel natural in the surgical flow.
The surgical environment added significant constraints. The surgeon's hands stay sterile and occupied with surgical instruments throughout the procedure, which meant every interaction had to happen through the foot switch. The aberrometer mounts on the surgical microscope, so the display had to work alongside the surgeon's primary visualization tool without obscuring it. Measurements had to be interpretable in under five seconds, with the patient under the microscope, the OR team waiting, and the next surgical step pending.
The device also had to support multiple measurement modes across the procedure: aphakic measurements after lens removal to guide IOL selection, pseudophakic measurements after IOL implantation to verify position, and toric axis measurements to align astigmatism-correcting lenses. Each mode required different information to be surfaced at the right moment, with the surgeon never needing to look away from the patient longer than necessary.
FIRST-IN-CLASS SURGICAL DEVICE
Solution
Designing UX for a product category that does not yet exist is a different problem than improving an existing device. There were no precedents to follow, no user expectations to meet, and no established mental model surgeons could draw on to interpret what the device was showing them. Every interaction had to be designed from observation of how cataract surgeons actually worked, then introduced in a way that would feel natural in the surgical flow.
The surgical environment added significant constraints. The surgeon's hands stay sterile and occupied with surgical instruments throughout the procedure, which meant every interaction had to happen through the foot switch. The aberrometer mounts on the surgical microscope, so the display had to work alongside the surgeon's primary visualization tool without obscuring it. Measurements had to be interpretable in under five seconds, with the patient under the microscope, the OR team waiting, and the next surgical step pending.
The device also had to support multiple measurement modes across the procedure: aphakic measurements after lens removal to guide IOL selection, pseudophakic measurements after IOL implantation to verify position, and toric axis measurements to align astigmatism-correcting lenses. Each mode required different information to be surfaced at the right moment, with the surgeon never needing to look away from the patient longer than necessary.