Abstract
Image-processing is an advantage of heads-up surgery and expected to facilitate ophthalmic surgeries. To evaluate image-processing quantitatively, we analyzed the surgical images of twenty eyes that underwent vitrectomy with internal limiting membrane (ILM) peeling assisted by Brilliant Blue G (BBG). Still images of the peeling procedure were obtained from the surgical video, and the color difference was calculated between two adjacent spots inside and outside the ILM-peeling contour, i.e., without and with BBG staining, respectively. The color differences were compared between the two settings with and without image-processing, delivered by an algorithm to enhance the color and contrast. Color differences were calculated using two methods: the Euclidean distance based on RGB values (RGB distance) and the Delta-E00 formula provided by the International Commission on Illumination. In five cases, minimum light intensities required to recognize the contour of ILM-peeling were compared during surgeries between the two settings with and without enhancement. Image-processing increased the mean color difference significantly (P < 0.001) from 15.47 and 4.49 to 34.03 and 8.00, respectively, for the RGB distance and Delta-E00. The minimum light intensity was reduced from 15 to 5 on average by image-enhancement. These results showed image-processing enhances color differences and reduces light intensities during vitrectomy.
Highlights
Image-processing is an advantage of heads-up surgery and expected to facilitate ophthalmic surgeries
A quantitative comparison between the digitally enhanced 3-D images and traditional microscopic observations was performed, and the brightness of the surgical images increased as a result of digital image-processing during HUS1
The enhancement effect on color and contrast is another advantage of digital image processing[1] and should contribute to better visualization of the surgical view and lower light intensity; objective and quantitative evaluations have not been performed previously
Summary
Image-processing is an advantage of heads-up surgery and expected to facilitate ophthalmic surgeries. Digital three-dimensional (3-D) displays have been introduced recently for use during ophthalmic surgeries, during which surgeons observe surgical views on a display instead of through the eye pieces of a surgical microscope[1,2,3,4,5,6,7,8,9]. This evolutionary technique often is referred to as heads-up surgery (HUS) based on the posture of the operating surgeon. We assessed the enhancement effect on visualization of membrane staining during vitrectomy using the software built into a display commercially available for medical use, and the effect of the enhancement to reduce the light intensity required for visualization of the surgical view
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