The Preliminary Experiences with Three-Dimensional Heads-Up Display Viewing System for Vitreoretinal Surgery under Various Status

Abstract

Statement: The current article has not been published elsewhere and has not been submitted simultaneously for publication elsewhere. Purpose: To investigate the preliminary use of three-dimensional (3D) heads-up display (HUD) viewing system for vitreoretinal surgery under various status. Materials and Methods: Nonrandomized case–control study. Consecutive cases to have vitreoretinal surgery under various status were prospectively recruited. Twenty-five-gauge vitrectomy platform and 3D viewing system were used. Main outcomes included: luminous emittance (lux) of endoillumination pipe, surgical duration, the surgeon and residents’ preference and ergonomics. Consecutive patients to have vitreoretinal surgery with the conventional viewing system were recruited as control group following the same inclusion and exclusion criteria and underwent surgeries by the same surgeon with the same microscope and vitrectomy platform. Results: Thirty-one patients (31 eyes; Group Study) and twenty-eight patients (28 eyes; Group Control) were included; without significantly statistical difference in terms of age, gender, main diagnosis, surgical duration, and difficulty rating between both groups (all P > 0.05). Lower endoillumination intensity was needed in Group Study than that in Group Control (10% vs. 35%; 598.7 ± 5.4 vs. 1913.0 ± 12.9 lux, P < 0.001). The surgeon and residents expressed overwhelming preference with the 3D system in both groups. Improved ergonomic was rated in Group Study (4.4 ± 0.8 vs. 3.2 ± 1.0, P < 0.001). Some intraoperative difficulties and discomforts appeared to the surgeon and assistants when using the 3D viewing system. Conclusion: Vitreoretinal surgery under various status can be well finished with the HUD platform by novice at the system. Main benefits included lower endoillumination intensity, enhanced users’ preference, and improved ergonomics. Some further refinements of the system are expected.