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Initial experience with three-dimensional heads-up display system for cataract surgery - A comparative study.

Jai A Kelkar¹, Aditya S Kelkar¹, Mounika Bolisetty¹

¹Department of Ophthalmology, National Institute of Ophthalmology, Pune, Maharashtra, India.

Indian Journal of Ophthalmology

|August 24, 2021

Summary

Phacoemulsification using a 3-D Heads-Up Display (HUD) system for cataract surgery is safe and offers excellent visualization, though it takes longer than conventional microscopes. Surgeons adapt well after approximately 50 cases.

Keywords:

3-D Heads up display system Conventional microscope phacoemulsification viewing system

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Area of Science:

Ophthalmology
Surgical Technology
Medical Devices

Background:

Conventional microscopy is standard for cataract surgery.
Newer technologies like 3-D Heads-Up Display (HUD) systems aim to improve surgical visualization and ergonomics.
Evaluating the safety, efficiency, and learning curve of these new systems is crucial.

Purpose of the Study:

To compare complication rates, surgical time, and the learning curve of the 3-D HUD system versus the conventional microscope for routine cataract surgery.
To assess the safety and efficacy of the ARTEVO 800 3-D HUD system in phacoemulsification.
To determine the surgeon's adaptation period with the 3-D HUD system.

Main Methods:

A comparative study involving consecutive adult patients undergoing phacoemulsification for uncomplicated cataracts.
Patients were randomized to surgery with either the 3-D HUD system (ARTEVO 800) or a conventional microscope (Zeiss Lumera 700).
Surgical time and complication rates were meticulously recorded and compared between the two groups.

Main Results:

Surgical time was significantly longer with the 3-D HUD system (8.4 ± 2.1 minutes) compared to the conventional microscope (6.5 ± 1.8 minutes).
No significant difference in complication rates was observed between the 3-D HUD group (2%) and the conventional microscope group (2.5%).
Complications in the 3-D HUD group occurred primarily in the first 50 cases, with conversions to a conventional microscope due to depth perception or illumination issues.

Conclusions:

Phacoemulsification using the 3-D HUD system provides superior visualization, ergonomics, and safety compared to conventional microscopes, despite a longer surgical time.
Experienced surgeons can achieve proficiency and overcome the initial learning curve with the 3-D HUD system after approximately 50 cases.
The 3-D HUD system represents a safe and effective advancement for cataract surgery, with potential benefits for surgeon comfort and patient outcomes.