Digitally assisted 3D surgery: Beyond vitreous

Author: Shilpi Narnaware (India)

Co-authors: Prashant Bawankule

Purpose

To evaluate the application and safety of 3D visualization system in varied anterior segment procedures and Scleral Buckle.

Setting/Venue

Sarakshi Netralaya, Nagpur, Maharashtra, India

Methods

A prospective observational study of 313 eyes. Patients undergoing phacoemulsification (PE) with Intra Ocular Lens (IOL) , Trabeculectomies, Glaucoma triple procedure (GTP), Scleral Fixated (SF) IOL and Scleral buckle (SB) were included. Cases were randomly distributed in 3D visualization system (Learning and post-learning phase) and conventional Microscope group. Parameters studied were complications (intra-operative and early post-operative), surgical outcomes, and surgeon’s perspective on various parameters (through a validated questionnaire) like surgical time, time lag, learning curve, ease of doing various steps and its value as an educational tool, for both groups.

Results

Complications rate were not different in 2 groups. Surgical outcomes (anatomical and physiological) were similar in both the groups. Mean duration of surgery in PE+IOL, Trabeculectomy, GTP in learning stage by 3D was significantly higher than Microscope, which became insignificant in post learning stage. For, SB and SFIOL, duration between 2 groups were insignificantly different. There was significant learning struggle in PE+IOL, SB and Trabeculectomy. Image resolution, depth perception, illumination and postural comfort was graded higher for 3D surgery across the stages. Time lag, poor color contrast and field of view was appreciated during the learning stage. Educational relevance of 3D was higher, as appreciated by resident and nurses.

Conlusions

3D surgery is as safe, faster and predictable after initial learning struggle. Even in anterior segment procedure, no apparent lag was appreciated after learning curve.

Financial Disclosure

No financial relations