Digital binocular surgical loupes for oculoplastic surgery using a three-dimensional digital camera and a virtual...

To evaluate the feasibility of virtual oculoplastic surgery using digital three-dimensional (3D) camera-based virtual-reality surgical magnification loupes.

A commercially available 3D video camera was used as an overhead binocular digital magnifying loupe, which projects a real-time 3D stereo image of the surgical field to a virtual-reality glasses worn by the surgeon and simultaneously records the surgical field. The surgeon used the digital binocular virtual surgical loupes (DBVSL) as the main source of visualization and magnification. The surgeon estimated the percentage of time he used the DBVSL as the sole method of visualization. The surgery was considered mainly performed using the DBVSL if it was estimated to be used for more than 50% of the procedure duration.

A total of 15 oculoplastic surgical procedures were attempted by three oculoplastic surgeons using the described digital binocular surgical loupes. Surgical procedures included chalazion incision and curettage (n = 4), eyelid mass excision with the closure of the wound by sutures (n = 6), frontalis sling (n = 2), levator tucking (n = 1), external dacryocystorhinostomy (n = 1), and eyelid splitting and anterior lamellar excision (n = 1). Fourteen out of 15 procedures could be successfully performed using the described DBVSL as the main method of visualization and magnification. Only the external DCR could not be mainly performed using the virtual surgical loupe.

DBVSL is a promising asset in oculoplastic surgery to provide sufficient surgical field magnification and surgical recording with the surgeon operating in a comfortable normally extended neck and back position. Further enhancements are required to improve the depth of focus, the stereoscopic depth clues and the ergonomics to make DBVSL versatile to different oculoplastic procedures.