Comparing microscope light-associated glare and comfort between heads-up 3D digital and conventional microscopes in cataract surgery: a randomised, multicentre, single-blind, controlled trial

Gualino, Vincent; Pierné, Kévin; Manassero, Anthony; Bruneau, S.; Couturier, Aude; Tadayoni, Ramin

doi:10.1136/bmjophth-2023-001272

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…Recently, however, digitally assisted surgery (DAS) has gained increasing attention [ 1 , 2 , 3 ]. This approach is considered useful for cataract surgery, glaucoma surgery [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ], and vitreous surgery [ 11 , 12 , 13 , 14 , 15 , 16 ]. DAS uses a microscope to view a three-dimensional (3D) monitor, thereby eliminating the need for an eyepiece.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, DAS enables surgery under low-light conditions. Digital surgery systems have the capability to enhance images with greater sensitivity than the actual light intensity, ensuring consistent brightness levels, whether in low-light or normal-light conditions during surgery [ 4 , 5 ]. For example, strabismus surgery can be performed without the use of the microscope light [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Image Quality and Reproducibility of Surgical Images in 3D Digital Surgery

Sakanishi,

Usui-Ouchi,

Morita

et al. 2024

JCM

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Objectives: Ophthalmic three-dimensional (3D) digital surgery can reproduce high-definition surgical images; however, 3D digital surgery is limited by recording capacities. We examined the relationship between the minimum image quality required to reproduce surgical images and recording capacity. Methods: Patients who underwent simultaneous vitrectomy and cataract surgery by the same surgeon using a 3D digital surgery system at Juntendo University Urayasu Hospital between February and October 2021 were evaluated. Various quality (Q) and frame rate (FR) settings were used for each case. Four vitreous surgeons evaluated the reproducibility of recorded images of macular manipulation for epiretinal membrane (ERM) and macular hole (MH) cases and those of peripheral retinal manipulation for rhegmatogenous retinal detachment (RRD) cases. The video bitrate and minimum settings required to reproduce surgical images and factors affecting surgical image reproducibility were examined. Results: A total of 129 eyes of 129 patients were observed. The minimum image quality required to reproduce surgical images was 11.67 Mbps. The Q and FR for periretinal processing and Q for macular manipulation affected surgical image reproducibility (p = 0.025, p = 0.019, and p = 0.07, respectively). The minimum recording settings required to obtain highly reproducible images were Q = 3 and FR = 40. The total file size for vitrectomy video recordings with these settings was as compact as 3.17 GB for 28 min. Conclusions: During 3D digital surgery, highly reproducible surgical images can be obtained with a small storage capacity using settings of at least Q = 3 and FR = 40.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship between Image Quality and Reproducibility of Surgical Images in 3D Digital Surgery

Sakanishi,

Usui-Ouchi,

Morita

et al. 2024

JCM

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Light as a drug: prospective randomized evaluation and comparison of the effect of decreased illumination on visual recovery after cataract surgery

Rosenberg,

Shah,

Sippel

et al. 2024

J Cataract Refract Surg

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Purpose: To compare the effect of decreased illumination on the rate of postoperative visual recovery, and the incidence of cystoid macular edema with surgical visualization achieved with a traditional analog operating microscope compared to a three-dimensional (3-D) digital visualization system. Setting: Ambulatory Surgery Center, New York Design: Prospective, randomized, consecutive, single surgeon series. Methods: Patients undergoing routine cataract surgery were randomized into either: (1) visualization via the binoculars of a standard operating microscope (“traditional group”), or (2) visualization via a 3-D digital visualization system affixed to the same operating microscope (“digital group”). Note was made in each case of light intensity utilized, light exposure time, cumulative dissipated energy (CDE), femtosecond laser use, preoperative medical and ocular conditions, intraoperative and/or postoperative complications, and pre- and postoperative visual acuities and optical coherence tomography confirmed cystoid macular edema (CME). Results: The study comprised 118 eyes in the traditional group and 96 eyes in the digital group. There were no differences in preoperative visual acuity, light exposure time, CDE, or femtosecond laser use between groups, but the light intensity utilized in the digital group was significantly less (19.5%±0.5%) than in the traditional group (48.6%±0.6%; p<0.001). Furthermore, the digital group achieved a better decimal postoperative day 1 visual acuity (0.60±0.03) with less rates of CME (2.1%) when compared to that of the traditional group (0.51±0.02,p=0.03; and 9.2%, p=0.03) respectively. Conclusions: Visual recovery and CME rates were significantly better in patients who underwent cataract surgery assisted by the 3-D digital visualization platform without an increase in complications or surgical time.

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3D Heads-up digital filters for cataract surgery and corneal transplantation

Mosca,

Scartozzi,

De Filippis

et al. 2024

European Journal of Ophthalmology

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Purpose To describe the advantages of Ngenuity 3D digital filters for enhancing visualization during cataract and corneal transplant surgery. Methods All surgeries were performed by the same experienced surgeon (L.M.) using the Ngenuity 3D heads-up visualization system connected to a microscope. Images were simultaneously captured with and without the filter in each of the following phases: endothelial evaluation, capsulorhexis, capsule rupture, vitreous leak, cortex removal, visco removal, corneal suture, descemetorhexis, DMEK graft preparation and insertion. Results In cataract surgery, green and monochrome filters facilitate capsulorhexis in difficult situations by highlighting the anterior capsule and can improve visualization of a posterior capsular tear. The enhanced contrast of the monochrome filter is also useful for cortex and viscoelastic removal. In corneal surgery, the green filter highlights the rim of the DMEK graft during tissue preparation, the yellow filter enhances the contrast of the stained DMEK graft in the anterior chamber, the monochrome filter simplifies descemetorhexis by improving visualization of the Descemet/endothelial layer and allows a better view in red saturated images while performing sutures. Conclusions Ngenuity digital filters have the potential to enhance tissue visualization during cataract and corneal surgeries, especially in poor visibility conditions.

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Comparing microscope light-associated glare and comfort between heads-up 3D digital and conventional microscopes in cataract surgery: a randomised, multicentre, single-blind, controlled trial

Cited by 3 publications

References 29 publications

Relationship between Image Quality and Reproducibility of Surgical Images in 3D Digital Surgery

Relationship between Image Quality and Reproducibility of Surgical Images in 3D Digital Surgery

Light as a drug: prospective randomized evaluation and comparison of the effect of decreased illumination on visual recovery after cataract surgery

3D Heads-up digital filters for cataract surgery and corneal transplantation

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