Abstract:PurposeTo introduce a hybrid wide-angle viewing-endoscopic vitrectomy, which we have reported, using a 3D visualization system developed recently.Subjects and methodsWe report a single center, retrospective, consecutive surgical case series of 113 eyes that underwent 25 G vitrectomy (rhegmatogenous retinal detachment or proliferative vitreoretinopathy, 49 eyes; epiretinal membrane, 18 eyes; proliferative diabetic retinopathy, 17 eyes; vitreous opacity or vitreous hemorrhage, 11 eyes; macular hole, 11 eyes; vit… Show more
“…49 A recent report describes the successful hybridization of ocular endoscopy with a 3D visualization system to manage vitreoretinal disease. 50 Despite clearly defined advantages, ocular endoscopy utilization remains low in part due to the ergonomic challenges of multiscreen off-axis viewing away from the main surgical field. DAVS based same screen simultaneous viewing of endoscopy video alongside the 3DHD surgical field video reduces these challenges.…”
The management of vitreoretinal cases is ever-evolving, paralleled by rapid advancements in operative imaging modalities. In this article, we describe an advanced application of digitally assisted vitreoretinal surgery (DAVS) that involves the consolidation of pre-existing ancillary imaging technology into a single same-screen viewing platform. Forty-four eyes of 44 patients were operated using same screen simultaneous viewing of the primary three-dimensional high definition (3DHD) surgical field and simultaneous auxiliary video feed viewing of all currently approved ocular endoscopy (n=12), intraoperative optical coherence tomography (iOCT) units (n=24), or computer feeds from the EHR/image management software (n=8). All surgeries were successful with excellent functional and anatomic outcomes. DAVS facilitated same screen viewing of multiple video/information feeds was notable for improved ergonomics, surgical efficiency, and precision when compared to viewing the surgical field and auxiliary video feeds separately. We describe a new concept for the vitreoretinal operating rooma DAVS-based surgical information handling cockpitintegrating FDA approved ocular endoscopy (n=1), microscope-integrated iOCT units (n=3), and one EHR/Image management solution with the primary surgical field 3DHD feed. We suggest same screen viewing of multiple video and other clinical information feeds is a promising modality that may be considered in the management of patients with surgical vitreoretinal disease and should be purposefully incorporated into future iterations of DAVS technology platforms.
“…49 A recent report describes the successful hybridization of ocular endoscopy with a 3D visualization system to manage vitreoretinal disease. 50 Despite clearly defined advantages, ocular endoscopy utilization remains low in part due to the ergonomic challenges of multiscreen off-axis viewing away from the main surgical field. DAVS based same screen simultaneous viewing of endoscopy video alongside the 3DHD surgical field video reduces these challenges.…”
The management of vitreoretinal cases is ever-evolving, paralleled by rapid advancements in operative imaging modalities. In this article, we describe an advanced application of digitally assisted vitreoretinal surgery (DAVS) that involves the consolidation of pre-existing ancillary imaging technology into a single same-screen viewing platform. Forty-four eyes of 44 patients were operated using same screen simultaneous viewing of the primary three-dimensional high definition (3DHD) surgical field and simultaneous auxiliary video feed viewing of all currently approved ocular endoscopy (n=12), intraoperative optical coherence tomography (iOCT) units (n=24), or computer feeds from the EHR/image management software (n=8). All surgeries were successful with excellent functional and anatomic outcomes. DAVS facilitated same screen viewing of multiple video/information feeds was notable for improved ergonomics, surgical efficiency, and precision when compared to viewing the surgical field and auxiliary video feeds separately. We describe a new concept for the vitreoretinal operating rooma DAVS-based surgical information handling cockpitintegrating FDA approved ocular endoscopy (n=1), microscope-integrated iOCT units (n=3), and one EHR/Image management solution with the primary surgical field 3DHD feed. We suggest same screen viewing of multiple video and other clinical information feeds is a promising modality that may be considered in the management of patients with surgical vitreoretinal disease and should be purposefully incorporated into future iterations of DAVS technology platforms.
“…Moreover, use of an endoscope makes it possible to observe the peripheral area of the fundus without any scleral indentation 1–4. Combining the use of a wide-angle viewing system and an endoscope as a visualization tool for each step of the surgery is referred to as “hybrid vitrectomy”, with the end result of a much more efficient procedure 5,6…”
Section: Discussionmentioning
confidence: 99%
“…We have previously reported on the efficacy of an ocular endoscope1–4 and on the combined use of a wide-angle viewing system and an endoscope, which we call “hybrid vitrectomy” 5,6. However, since an ocular endoscope can only provide a two-dimensional (2D) view, it is necessary to create an empirical stereoscopic vision during the endoscopy.Figure 1The wide-angle viewing image is integrated on the large NGENUITY 3D monitor (right) that is placed at the foot of the surgical bed.…”
PurposeTo introduce a new three-dimensional (3D) endoscope system for vitrectomy.Subjects and methodsWe report a single-center, retrospective, consecutive surgical case series of 391 eyes that underwent 25G hybrid vitrectomy. To create 3D endoscopic images, a 3D converter HD-3D-A was connected to a monocular endoscopic system.ResultsThe 3D endoscope system was successfully used to perform hybrid vitrectomy. No intra- or postoperative complications related to this system were encountered in any of the cases.ConclusionThis 3D endoscope system appears to be a valuable and promising tool for use in vitrectomy.
“…Its rst use in cataract surgery was reported by Weinstock in 2008, while Riemann stated that 3D system was introduced in vitrectomy world starting from 2010. 3D heads up surgery not only display a better image with manipulation of colour and brightness of images, but it also enables access to multiple images at the same time such as images of the optical coherence tomography (OCT) and endoscopic view [10]. 3D visualization in OCT and its implementation in vitreoretinal surgeries resulted in higher success rate [11,12,13].…”
Section: Introductionmentioning
confidence: 99%
“…In a retrospective surgical case series involving 113 of vitrectomies and 90 phacoemulsi cations revealed that none of these cases converted from the 3D surgery to the traditional ophthalmic surgery [10].…”
Background The purpose of this study is to evaluate the satisfaction of surgeons and postgraduate trainees on 3D heads up ophthalmic surgery compared to traditional microscopic surgery in terms of working and educational aspect.Methods This was a validated questionnaire-based study. This study was conducted at a tertiary referral and postgraduate teaching hospital in Kuala Lumpur, Malaysia over a one-month period during which the Ngenuity viewing system was demonstrated in the Ophthalmology operating theatre. All surgeons and trainees exposed to the viewing system were recruited for the study which involved answering an online questionnaire comprising the components of visualization, physical, ease of use, teaching and learning components and a question on satisfaction. This questionnaire is designed to evaluate the perception of the students and surgeons regarding learning-teaching methodology and benefits gained by them comparing between 3D heads up system and traditional microscopic surgery.Results All seven surgeons and 33 postgraduate students responded to the survey. A total of 32 cases were operated with the 3D system, which consisted of phacoemulsification, pterygium surgery, glaucoma procedures, cornea and vitreoretinal operations. There was no significant difference reported by the surgeons in all specific components (p>0.05, paired t-test). Postgraduate trainees reported better experience with 3D heads up surgery compared to traditional microscopic operation in terms of the illumination (p=0.008) and manoeuvrability (p= 0.01), physical factors such as glare p=0.037), eye strain (p=0.008), neck and upper back pain (p=0.000), lower back pain (p=0.019) and for all subcomponents of teaching and learning. Both surgeons and postgraduate trainees were more satisfied with 3D heads up system in general than traditional microscopic surgery (p=0.047 and p=0.009 respectively).Conclusions 3D heads up surgery and viewing is preferred to traditional microscopic surgery viewing particularly by postgraduate trainees. The overall satisfaction with this viewing system is also higher among surgeons and trainees than traditional microscope viewing.Trial Registration: Reference number: UKM PPI/111/8/JEP-2019-724 (UKM Research Ethics Committee) Date: 6th November 2019
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