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Mark Barakat; Learning to use a stereoscopic display with retinal surgery does not increase surgical time or negatively affect outcomes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4457.
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© ARVO (1962-2015); The Authors (2016-present)
The visualization system TrueVision® is a stereoscopic, real-time, digital display of the surgical arena intended for cataract, glaucoma and vitreoretinal surgery. There is some data to suggest that it is safe and effective in achieving robust surgical outcomes in refractive cataract surgery, but less is known about results in retinal surgery. We hypothesize that transitioning to this "heads-up" display will not lead to increased surgical time or complication rate, even during the initial learning curve.
All retinal surgery cases performed by a single surgeon with 25 gauge vitrectomy (Alcon Constellation® unit) at one outpatient facility in September and October of 2015 were reviewed retrospectively. All consecutive cases on/after September 30, 2015, were performed with the “heads-up” display. Intraoperative reports, operative and clinical notes were reviewed for surgical time, complications, and visual acuity (VA) at baseline, 1 day, 1 week, and 1 month after surgery. Cases were further subdivided into complexity categories by diagnosis:● vitreous hemorrhage/debris and silicone oil,● epiretinal membrane and macular hole,● rhegmatogenous retinal detachment,● complex retinal detachment and dislocated intraocular lens.
Of the 32 consecutive cases performed at this center, 18 were performed with the surgical microscope and 14 with the digital display. Average surgical times for the TrueVision® and standard groups were statistically equivalent at 41.5±15.5 and 34.1±20.6 minutes (p = 0.27), respectively. Two-way analysis of variance (ANOVA) of operative times confirmed a significant correlation with disease category (p = 0.000018) but not viewing system (p = 0.093). Mean logarithm of Minimum Angle of Resolution (logMAR) baseline VA was equivalent in both TrueVision® and standard groups (1.00±0.94 vs 0.84±0.76; p = 0.62), as was change in logMAR VA at all post-operative time points (p = 0.12; 0.77; 0.14). There were no complications in either group.
Early experience with transitioning away from the standard operating microscope to the TrueVision® viewing system did not yield increased surgical time or complication rate in retinal surgery. Short-term visual outcomes did not differ. Additional analysis is needed to further explore long-term outcomes and potential benefits of this digital system with increasing surgeon familiarity.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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