This video demonstrates an image-sharpening algorithm intended to enhance visualization for 3D heads-up surgery in small-gauge pars plana vitrectomy (PPV). An image-sharpening device (Medical Image Enhancer: MIEr, Logic & Design) was used for 3D heads-up surgery with the Artevo 800 system (Carl Zeiss Meditec) in PPV for lamellar macular hole, epiretinal membrane, and diabetic macular edema. The device has 2 parameters of intensity for the image-sharpening algorithm and color intensity. The dark intraocular area under single light guide was rendered brighter by the image-sharpening device, and the border of the epiretinal membrane was more clearly delineated. The inner limiting membrane itself and its borders were clearly defined by increasing the color intensity under brilliant blue G dye. Overall, the image-sharpening device enabled brighter intraocular images, clarifying tissue boundaries and brightening color intensity to achieve color filter-like function.

Financial Disclosures: Dr. Makoto Inoue discloses financial relationships with Alcon Laboratories, Inc. (Lecture Fees/Speaker Bureau, Grant Support); Bayer Healthcare Pharmaceuticals (Lecture Fees/Speakers Bureau); Carl Zeiss Meditec (Lecture Fees/Speakers Bureau); Hoya Corporation (Lecture Fees/Speakers Bureau); Johnson & Johnson (Lecture Fees/Speakers Bureau); Kowa American Corporation (Lecture Fees/Speakers Bureau); Novartis, Alcon Pharmaceuticals (Lecture Fees/Speakers Bureau); Santen (Lecture Fees/Speakers Bureau); and Senju Pharmaceuticals Co., Ltd. (Lecture Fees/Speakers Bureau).