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Use of 3D visualization system in deep sclerectomy: preliminary results from a pilot study
Agostino S Vaiano1, Antonio Greco2, Luca Scartozzi2
1Department of Ophthalmology, Santa Croce e Carle hospital, Michele Coppino, Cuneo, Italy. vaiano.a@ospedale.cuneo.it.
Objective:
To evaluate the application of three-dimensional (3D) visualization technology during non-penetrating glaucoma surgery (deep sclerectomy, DS), analyzing its advantages in terms of surgical ergonomics, operative precision, and educational potential.
Methods:
The outcomes of a prospective series of 12 patients with open-angle glaucoma undergoing DS assisted by 3D technology were reported. An educational questionnaire was administered to ophthalmology trainees to rate the level of satisfaction on a 5-point Likert scale. Duration of surgery was compared to a previous cohort of patients undergoing DS using conventional optical microscope.
Results:
Surgical procedures of 12 patients (6 male, 6 females, mean age 72,5 y.o.) undergone DS were reviewed. The application of 3D technology in DS demonstrated tangible advantages, including improved visualization of anatomical structures (trabecular meshwork, Schlemm's canal, Descemet's membrane), better postural comfort for the surgeon, and more effective sharing of the surgical field with the entire team. No cases of intraoperative perforation were observed. Median operative times were 45.0 min (IQR 4.3) in the 3D group and 44.6 min (IQR 5.1) in the conventional group (p = 0.78). A mean score of 4,23/5 was registered.
Conclusions:
The integration of 3D visualization in DS represents a promising evolution, enhancing surgical precision and improving ergonomics. The educational benefits are particularly relevant in the academic setting. Controlled prospective studies are needed to confirm these findings in long-term clinical parameters.

