Use of the Three-dimensional Viewing System and Microscope Tilting to Extend the Peripheral Retinal View

To describe and evaluate the effectiveness of the microscope and lens tilting technique associated with the three-dimensional viewing system for improving the peripheral retinal view in noncontact lens vitreoretinal surgeries.

Prospective, single-center, single-surgeon, consecutive case series of 25 patients undergoing vitrectomy for macular surgeries with three-dimensional visualization system. At the end of each surgery, the microscope and the noncontact lens were rotated by 20° in a direction opposite to the rotation of the eye to extend the peripheral visual field.

Microscope and lens tilting technique extended the edge of the peripheral viewing field relative to its position with the microscope untilted, by 1.72 mm (±0.37) for the superior retina and 1.93 mm (±0.42) for the inferior retina (P < 0.0001). The ora serrata was visualized in 33% and 0% of cases for the superior retina and 91% and 36% of cases for the inferior retina, in tilted and nontilted microscope positions, respectively (P < 0.01).

Microscope and lens tilting could be useful to extend the peripheral visual field of view in retinal surgery. The three-dimensional system allowed to maintain surgeon comfort and posture during surgery.