Abstract
Objective
To compare surgical efficiency, visual and physical comfort, and safety profile of
the ARTEVO 800 Digital Microscope (Carl Zeiss Meditec AG, Jena, Germany) and the Ngenuity
3D Visualization System (Alcon Laboratories Inc, Fort Worth, Tex.) in cataract surgery.
Design
Cross-sectional study.
Participants
One hundred consecutive phacoemulsification cataract surgeries performed by five surgeons
from June 1, 2020, to November 1, 2020.
Methods
For each case, the surgeons answered a 2-section questionnaire (before and after intervention)
to collect data on cataract severity or grade, surgical risk, chosen three-dimensional
(3D) visualization system, surgical complications, and the visual or physical discomfort
experienced during the procedure.
Results
Each of the 5 surgeons performed 20 surgeries (N = 100) using either the ARTEVO 800
Digital Microscope (N = 50) or the Ngenuity Visualization System (N = 50). Mean duration
of the surgical procedure was 17.07 ± 4.80 minutes, and none of the surgeons ever
switched to the classical microscope. In addition, 40% of surgeries were considered
at low risk, 30% at intermediate risk, and 30% at high risk. The Zoom, Focus, and
XY commands were used 1–3 times, respectively, during 76 (p = 0.34), 73 (p = 0.49), and 76 (p = 0.64) interventions. Surgical uncertainty and operative fluency were similar using
both systems (p = 0.53 and p = 0.19). We observed 14 intraoperative complications, 9 using Ngenuity and 5 using
the ARTEVO 800. Surgeon's visual comfort (p = 0.79), colour or brightness perception (p = 0.82), and visual impairment (p = 0.62) during surgery were similar for both systems. Headache, backache, and other
musculoskeletal problems were reported, respectively, after 14 (p = 0.79), 11 (p = 0.99), and 8 (p = 0.44) procedures.
Conclusion
Both the Ngenuity 3D Visualization System (Alcon Laboratories Inc) and the ARTEVO
800 Digital Microscope (Carl Zeiss Meditec AG) provided comparable operative speed
and overall surgical comfort during cataract surgery.
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References
- Heads-up cataract surgery with the TrueVision 3D display system.in: Garg A Alio JL Surgical techniques in ophthalmology: cataract surgery. New Dehli. Jaypee Medical Publishers, India2010: 124-127
- Heads-up surgery for vitreoretinal procedures: an experimental and clinical study.Retina. 2016; 36: 137-147
- The case for 3-D.Retina. 2015; : 76-78
- Heads-up cataract surgery: complication rates, surgical duration, and comparison with traditional microscopes.J Refract Surg. 2019; 35: 318-322
- Comparative assessment of ergonomic experience with heads-up display and conventional surgical microscope in the operating room.Clin Ophthalmol. 2021; 15: 347-356
- Use of the heads-up NGENUITY 3D visualization system for vitreoretinal surgery: a retrospective evaluation of outcomes in a French tertiary center.Sci Rep. 2021; 11: 10031
- Three-dimensional display systems in ophthalmic surgery: a review.Eur Ophthal Rev. 2019; 13: 31
- G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.Behav Res Methods. 2007; 39: 175-191
- Lens opacities classification system.Arch Ophthalmol. 1988; 106: 330-334
- Clinical experience of using the NGENUITY three-dimensional surgery system in ophthalmic surgical procedures.Acta Ophthalmol. 2021; 99: e101-e108
- Perceptions of the surgical team.Retina. 2018; 38: 857-861
- Biaxial microincision versus coaxial small-incision clear cornea cataract surgery.Ophthalmology. 2006; 113: 1818-1826
- The Use of Research Electronic Data Capture (REDCap) software to create a database of librarian-mediated literature searches.Med Ref Serv Q. 2014; 33: 241-252
- The REDCap Consortium: building an international community of software platform partners.J Biomed Inform. 2019; 95103208
- Comparison of microscopic illumination between a three-dimensional heads-up system and eyepiece in cataract surgery.Eur J Ophthalmol. 2021; 31: 1817-1821
- Comparing clinical outcomes of macular hole surgeries performed by trainee surgeons using a 3D heads-up display viewing system versus a standard operating microscope.Int Ophthalmol. 2021; 41: 2649-2655
- The scope of three-dimensional digital visualization systems in vitreoretinal surgery.Clin Ophthalmol. 2019; 13: 2093-2096
- Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy Using a Novel Digital Microscope with Integrated Intraoperative Optical Coherence Tomography.J Ophthalmol. 2020; : 9024241https://doi.org/10.1155/2020/9024241
- Vergence-accommodation conflicts hinder visual performance and cause visual fatigue.J Vision. 2008; 8: 1-30
- Can the three-dimensional heads-up display improve ergonomics, surgical performance, and ophthalmology training compared to conventional microscopy?.Clin Ophthalmol. 2021; 15: 679-686
- Learning curve of three-dimensional heads-up vitreoretinal surgery for treating macular holes: a prospective study.Int Ophthalmol. 2019; 39: 2353-2359
Article Info
Publication History
Published online: September 22, 2021
Accepted:
August 25,
2021
Received in revised form:
July 18,
2021
Received:
April 5,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
