Enhanced Surgical Efficiency with 3D Heads-Up Visualization in Vitreoretinal Surgery: A Retrospective Comparative...

Area of Science:

• Ophthalmology
• Surgical Technology
• Retina Surgery

Background:

• Vitreoretinal surgery traditionally relies on operating microscopes.
• Advancements in digital visualization offer potential benefits for surgical procedures.
• Comparing conventional microscopy with 3D heads-up systems is crucial for optimizing surgical techniques.

Purpose of the Study:

• To compare intraoperative parameters, structural safety, and functional outcomes of vitreoretinal procedures using a conventional microscope versus a 3D heads-up system.
• To evaluate the impact of the 3D system on surgical duration, endoillumination intensity, and visual acuity.
• To assess the anatomical success rates and complication profiles of both visualization systems.

Main Methods:

• Retrospective analysis of 248 pars plana vitrectomies for epiretinal membrane (ERM), macular hole (MH), or rhegmatogenous retinal detachment (RRD).
• Patients were divided into conventional microscope (n=122) and 3D heads-up (n=126) groups.
• Outcomes included surgical duration, endoillumination, best-corrected visual acuity (BCVA), anatomical success, and complications over 6 months.

Main Results:

• The 3D heads-up system group demonstrated significantly shorter surgical duration (50.0 vs. 60.0 min, p=0.001).
• Lower endoillumination intensity was required with the 3D system (p ≤ 0.002).
• High and comparable anatomical success rates and visual improvements were observed in both groups, with similar complication rates.

Conclusions:

• The 3D heads-up visualization system provides comparable functional and anatomical outcomes to conventional microscopy in vitreoretinal surgery.
• The 3D system allows for surgery under reduced light conditions and optimizes operative time, especially for ERM peeling.
• The 3D heads-up system maintains an equivalent structural safety profile to conventional surgical methods.