Abstract
Heads-up three-dimensional (3D) surgical visualization systems allow ophthalmic surgeons to replace surgical microscope eyepieces with high-resolution stereoscopic cameras transmitting an image to a screen. We investigated the effectiveness and safety of the heads-up NGENUITY 3D Visualization System in a retrospective evaluation of 241 consecutive vitreoretinal surgeries performed by the same surgeon using conventional microscopy (CM group) over a 1-year period versus the NGENUITY System (3D group) over a consecutive 1-year period. We included for study vitreoretinal surgeries for treatment of retinal detachment (RD) (98 surgeries), macular hole (MH) (48 surgeries), or epiretinal membrane (ERM) (95 surgeries). A total of 138 and 103 eyes were divided into 3D and CM groups, respectively. We found no differences in 3-month postoperative rates of recurrence of RD (10% versus 18%, p = 0.42), MH closure (82% versus 88%, p = 0.69), or decrease in central macular thickness of ERMs (134 ± 188 µm versus 115 ± 105 µm, p = 0.57) between the 3D and CM groups, respectively. Surgery durations and visual prognosis were also similar between both groups. We consolidate that the NGENUITY System is comparable in terms of visual and anatomical outcomes, giving it perspectives for integration into future robotized intervention.
Highlights
The first fixed surgical microscopes arrived in the 1920s with Nylen, a Swedish ear, nose, and throat specialist, but it was not until 1946 that Perritt from Chicago made use of one for ophthalmology s urgery1–6. Barraquer[4] testified in 1980 that microscopes had made it possible to visualize previously inaccessible eye structures, and to develop more precise surgical techniques, smaller instruments, and finer suture materials
Heads-up 3D surgical visualization systems allow ophthalmic surgeons to replace conventional surgical microscope eyepieces with cameras retransmitting an image on a screen in front of them
We did not find any significant differences in terms of visual outcomes, anatomical outcomes, or surgery durations between both techniques for the surgical treatment of retinal detachment (RD), epiretinal membrane (ERM), and macular hole (MH)
Summary
The first fixed surgical microscopes arrived in the 1920s with Nylen, a Swedish ear, nose, and throat specialist, but it was not until 1946 that Perritt from Chicago made use of one for ophthalmology s urgery1–6. Barraquer[4] testified in 1980 that microscopes had made it possible to visualize previously inaccessible eye structures, and to develop more precise surgical techniques, smaller instruments, and finer suture materials. The advent of phacoemulsification by K elman[7], pars plana vitrectomy by Machemer et al.[8], and non-perforating filtration surgery by K rasnov[9] was during the 1960s and 1970s The contribution of these techniques was considerable to the treatment of many diseases. Heads-up three-dimensional (3D) surgical visualization systems allow ophthalmic surgeons to free themselves of the eyepieces of conventional surgical microscopes, and to replace them by high-resolution dual-camera systems that retransmit an image on a screen in front of the surgeon. This switch to all-digital technology represents a major breakthrough in the conception of surgical microscopes in ophthalmology. We describe the benefits and drawbacks of using the NGENUITY System according to both our experience and reports in the literature
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