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Takashi Kitaoka, Yuki Hara, Makiko Matsumoto, Eiko Tsuiki; 3D Heads-up vitreo-retinal surgery with intraoperative OCT and intraocular endoscopy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2796.
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Many Ophthalmologists suffer from cervical and lumber spine symptoms. Heads-up surgeries may resolve these problems. The purpose of this study is to evaluate Pros and Cons in 3-D heads-up vitreo-retinal surgery with intraoperative OCT (iOCT) and intraocular endoscope.
We performed vitreo-retinal surgery under 3D visualization system with heads-up display using Zeiss Rescan microscope equipped with two high vision cameras. During surgery, the surgeon wore 3D polarized glasses to obtain stereoscopic view with high definition monitor, and used iOCT and endoscope in some cases. In this study, 24 eyes of 23 patients were enrolled and underwent 25-gauge vitrectomy for variety of diseases, including proliferative diabetic retinopathy (8 eyes), vitreous hemorrhage after central retinal vein occlusion (1 eye), epiretinal membrane (2 eyes), macular hole (7 eyes), macular hole retinal detachment (2 eyes), myopic retinaol schisis (1 eye), rhegmatogeous retinal detachment (2 eyes) and endophthalmitis (1 eye).
Resolution of image was almost 1 minute same as conventional microscopic observation. Although we observed that the whitish proliferative tissues in vitrectomy operations were fogged by halation, which prevented precise observation, we got favorable results in all cases. For example, all macular holes were closed and retinas were attached in all detachment cases. In 3 cases, we performed ILM inverted technique and successful coverage of ILM was confirmed by iOCT. In 2 cases (proliferative diabetic retinopathy and endophthalmitis), we carried out successful vitrectomy in peripheral area under endoscope. In addition, we believe that heads-up display position is superior in ergonomics aspect.
We got favorable results by heads-up display surgery and it is suitable for vitrectomy.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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