Minimal Endoillumination Levels and Display Luminous Emittance During Three-Dimensional Heads-Up Vitreoretinal Surgery

Adam, Murtaza K.; Thornton, Sarah; Regillo, Carl D.; Park, Carl; Ho, Allen C.; Hsu, Jason

doi:10.1097/iae.0000000000001420

Cited by 76 publications

(63 citation statements)

References 13 publications

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“…There were two serious complications in the BM group (zonular dialysis and posterior capsular rent with sulcus implantation) and one in the 3D group (lens touch) out of the 9 complications reported among all procedures. Among other studies assessing intraoperative complications, one lens touch in a 25-G 3D-assisted vitreoretinal procedure [7] or no complications in a 3D-assisted surgery cohort of 31 eyes [3],10 eyes [4], or 23 eyes [9] was reported.…”

Section: Safetymentioning

confidence: 99%

“…Along with other assessments, the 3D system was found to offer greater comfort for the primary surgeon. It also reduced the intensity of endoillumination, with a possible reduced risk of retinal damage, and also increased the depth of field and colour contrast [3][4][5][6][7][8]. The aim in this study was to evaluate the efficiency, comfort, and safety of a 3D visualization system compared to a standard BM, in the context of routine ophthalmologic procedures at a midsized university hospital.…”

Section: Introductionmentioning

confidence: 99%

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Comparing Heads-Up versus Binocular Microscope Visualization Systems in Anterior and Posterior Segment Surgeries: A Retrospective Study

et al. 2020

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Background: Three-dimensional (3D) visualization systems, also known as heads-up systems, are now available for eye surgery and as with every new device there is need for a specific evaluation. Objectives: The aim of this study was to compare the efficiency, surgical comfort, and safety of a 3D visualization system to a standard binocular microscope (BM) in routine ophthalmologic procedures. Method: After a 4-week training period, a 3D visualization system (Ngenuity, Alcon ®) available in one of the Robert Debré Hospital Ophthalmology Departments' operating rooms was compared to a standard BM (OPMI LUMIRA 700, Zeiss ®), in the process of a call for new device evaluation. From December 2017 to March 2018, 5 surgeons and their respective residents were asked to fill in a questionnaire for all procedures. Before the surgery, the surgeon recorded: (i) the type of surgery (cataract [PK], retinal detachment [RD], epiretinal membrane peeling [ERM], macular hole, vitreous haemorrhage [VH]), (ii) the type of visualization system chosen (3D or BM), and (iii) the estimated surgical risk (low, intermediate, or high grade). At the end of the procedure, the primary surgeon recorded

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Section: Safetymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing Heads-Up versus Binocular Microscope Visualization Systems in Anterior and Posterior Segment Surgeries: A Retrospective Study

et al. 2020

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“…Similarly, Adam et al [18] found that in 9 out of 10 cases (five 23-G, one 25-G, and three 27-G), the surgeon felt comfortable at an endoillumination level of 10% with an associated average of 14.3 ± 9.5 lux emitted from the 3-D heads-up display surgical platform. In the remaining case (27-G), the operating surgeon felt comfortable at a 3% endoillumination level with a corresponding heads-up display emittance of 15 lux.…”

Section: Light Sourcesmentioning

confidence: 84%

“…Recently, the advent of 3-dimensional (3-D) heads-up vitreoretinal surgery offers a potential solution to the phototoxicity issue by enabling digital amplification of camera signals, and thus requiring relatively low endoillumination parameters [18] .…”

Section: Light Sourcesmentioning

confidence: 99%

Importance of Light Filters in Modern Vitreoretinal Surgery: An Update of the Literature

Coppola¹,

Cicinelli²,

Rabiolo³

et al. 2017

Ophthalmic Res

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Purpose: Direct endobulbar illumination during vitreoretinal surgery causes light-induced retinal damage known as phototoxicity. Spectral filters have been proposed to eliminate hazardous wavelengths from the emission spectrum before entering the eye. The purpose of our paper is to review advances in vitreoretinal surgery, focusing on intraoperative light filters. Methods: A PubMed and Medline database search was carried out using the terms “spectral filters” associated with “vitreoretinal surgery,” “phototoxicity,” and “vitrectomy.” Original articles, reviews, and book chapters up to March 2017 were reviewed; a few select articles published before 2000 are included for historical purposes. Material from recent meeting presentations was also added. The preferred language for the reviewed literature was English. Results: Spectral filters significantly reduce the risk of phototoxicity associated with endoillumination in vitreoretinal surgery, allowing higher exposure times than with optic light fibers alone. Spectral filters may affect intraoperative luminance, but do not alter color contrast. Amber filters showed superiority over green and yellow filters. Conclusion: The choice of light sources coupled to spectral filters is strongly suggested, especially in dye-assisted chromovitrectomy. Histological donor eye studies and large multicenter trials are needed to validate the amount of photoprotection provided by spectral filters before a general recommendation can be made.

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“…In addition, as the main element of VR, 3D technology has been applied to surgical training by medical students [3][4][5]. In recent years, a new surgical method using the 3D technology called heads-up surgery has been proposed and clinically used [6,7]. The heads-up technique is expected to reduce neck and back pain, especially after prolonged surgery, and to improve the performance of surgery with new technology such as digital image processing.…”

Section: Introductionmentioning

confidence: 99%

P‐198: Late‐News Poster: Clinical Utility of Stereoscopic 3D Displays in Heads‐up Surgery

Shibata

Shiraki

Kamei

2018

Symp Digest of Tech Papers

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Minimal Endoillumination Levels and Display Luminous Emittance During Three-Dimensional Heads-Up Vitreoretinal Surgery

Abstract: With real-time digital processing and automated brightness control, 3-dimensional HUD platforms may allow for reduced intraoperative endoillumination levels and a theoretically reduced risk of retinal phototoxicity during vitreoretinal surgery.

Cited by 76 publications

References 13 publications

Comparing Heads-Up versus Binocular Microscope Visualization Systems in Anterior and Posterior Segment Surgeries: A Retrospective Study

Comparing Heads-Up versus Binocular Microscope Visualization Systems in Anterior and Posterior Segment Surgeries: A Retrospective Study

Importance of Light Filters in Modern Vitreoretinal Surgery: An Update of the Literature

P‐198: Late‐News Poster: Clinical Utility of Stereoscopic 3D Displays in Heads‐up Surgery

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