Comparing Heads-Up versus Binocular Microscope Visualization Systems in Anterior and Posterior Segment Surgeries: A...

Area of Science:

• Ophthalmology
• Surgical Technology
• Medical Imaging

Background:

• Three-dimensional (3D) visualization systems, also known as heads-up systems, are increasingly available for eye surgery.
• Evaluation of new surgical devices is crucial for adoption and integration into practice.

Purpose of the Study:

• To compare the efficiency, surgical comfort, and safety of 3D visualization systems against standard binocular microscopes (BM) in ophthalmologic procedures.
• To assess the impact of 3D visualization on cataract surgery (PK) and vitreoretinal surgeries.

Main Methods:

• A comparative study involving 5 surgeons and residents over 4 months, using a 3D system (Ngenuity) and a standard BM (OPMI LUMIRA 700).
• Data collected included surgery type, duration, complications, visual comfort, operative fluency, and surgeon-reported backaches and headaches.
• Statistical analysis included univariate and multivariate models to identify factors associated with surgery duration.

Main Results:

• Analysis of 102 procedures (73 PK, 29 vitreoretinal) revealed similar safety profiles and comfort levels between 3D and BM systems.
• 3D visualization led to significantly faster cataract surgeries (PK) (16.44 min vs. 21.44 min, p=0.007) and slightly improved operative fluency.
• No significant differences were observed in vitreoretinal surgeries, with a slight decrease in operative fluency noted with the 3D system.

Conclusions:

• 3D visualization systems are safe for routine ophthalmic practice.
• The use of 3D technology enhances operative fluency and reduces surgery time for cataract procedures.
• Further evaluation may be needed for optimal application in vitreoretinal surgeries.