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. 2023 Mar;261(3):669-679.
doi: 10.1007/s00417-022-05850-z. Epub 2022 Oct 10.

Surgery-related characteristics, efficacy, safety and surgical team satisfaction of three-dimensional heads-up system versus traditional microscopic equipment for various vitreoretinal diseases

Xin-Yu Zhao #  1   2 , Qing Zhao #  1   2 , Ning-Ning Li  3 , Li-Hui Meng  1   2 , Wen-Fei Zhang  1   2 , Er-Qian Wang  1   2 , You-Xin Chen  4   5
Affiliations

Surgery-related characteristics, efficacy, safety and surgical team satisfaction of three-dimensional heads-up system versus traditional microscopic equipment for various vitreoretinal diseases

Xin-Yu Zhao et al. Graefes Arch Clin Exp Ophthalmol. 2023 Mar.

Abstract

Purpose: To compare the three-dimensional (3D) heads-up surgery with the traditional microscopic (TM) surgery for various vitreoretinal diseases.

Methods: A medical record review of patients that underwent 3D heads-up or TM vitreoretinal surgeries was performed from May 2020 to October 2021 in this retrospective case-control study. Main outcome measures included surgery-related characteristics, efficacy, safety, and satisfaction feedback from the surgical team.

Results: A total of 220 (47.6%) and 242 (52.4%) eyes were included in the 3D and TM groups, respectively. The 3D heads-up system significantly benefits delicate surgical steps, like the epiretinal membrane (ERM) peeling for ERM and internal limiting membrane peeling for idiopathic macular holes (P < 0.05). The 3D heads-up system could facilitate a significantly better visual outcome for pathologic myopic foveoschisis (P = 0.049), while no difference by TM surgery (P = 0.45). For the satisfaction feedback, the 3D heads-up system was rated significantly higher in most subscales and the overall score (P < 0.05). The surgeons' ratings on operating accuracy and the first assistants' rating on operating accuracy and operation cooperation were significantly higher in the TM group than in the 3D group (P < 0.05). Besides that, the 3D heads-up surgery was comparable with TM surgery in the surgery-related characteristics, choice of tamponades, postoperative VA, primary anatomic success, and perioperative complications (P > 0.05).

Conclusion: The efficacy and safety of the 3D heads-up surgery were generally comparable to the TM surgery. The 3D heads-up system could significantly benefit delicate surgical steps and achieve better surgical team satisfaction.

Keywords: Efficacy; Safety; Satisfaction; Three-dimensional heads-up surgery; Vitreoretinal surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
a The surgical team during the surgery using the 3D heads-up visualization system. Every member in the surgical team wore passive polarized 3D glasses and viewed the surgical field on the Advanced NGENUITY® 3D 4 K OLED Display. The NGENUITY® 3D Visualization System and the CONSTELLATION® Vision System establish an Integrated Surgical Platform, which could monitor the real-time IOP, flow rate, and other surgical parameters. b The Alcon NGENUITY® 3D Visualization System. Abbreviations: ILM = internal limiting membrane; IOP = intraocular pressure; 2D = two-dimensional; 3D = three-dimensional
See this image and copyright information in PMC

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