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William R Freeman, Kevin Chen, Daniel Chao, Henry Ferreyra, Eric Nudleman, Dirk-Uwe G Bartsch; Low versus Standard Latency Digital 3D Monitor Visualization for Ophthalmic Surgery. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5916.
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© ARVO (1962-2015); The Authors (2016-present)
We compared two digitally assisted 3D visualization systems for ophthalmic surgery to traditional optical stereo microscopic surgery. Both anterior segment and vitreoretinal surgeries were studied. The goal was to determine if digitally assisted 3D visualization surgery using the one of two TruVision systems (distributed by Alcon) were equivalent to, superior or inferior to traditional microscopic surgery.
8 surgeons evaluated two digital surgical systems that were mounted onto a Leica ophthalmic microscope and compared to traditional ocular surgery. The first digital system consisted of a dual HD video system coupled to a 4K display with a 55-inch OLED screen placed 6 feet from the surgeon. The second system consisted of the same camera head but used a low latency 72 millisecond OLED monitor. Both monitors incorporated a passive stereoscopic display using interlaced lines with alternating circular polarization.
320 vitrectomy procedures and 80 cataract procedures were performed on the digital system and 140 procedures were performed on the same microscope but using oculars. In no case did any surgeon starting with the digital system require reversion to a traditional ocular system. All surgeons felt that the ability to view and surgically deal with pathology was similar to routine optical microscope surgery. However, the brightness of the image and the ability to enhance the stereopsis were advantages over optical microscopy, as was increased engagement of surgical staff who also wore stereo viewing glasses. Lag time was only perceptible with fast gross movements and became nearly imperceptible with the use of the low latency monitor.
Digitally assisted vitreoretinal surgery seems equivalent to optical surgery in anterior and posterior segment procedures from the perspective of surgical visualization and surgeon preference. Ultra-low latency monitors (under 40 msec) can reduce perceptible latency. The immersive environment of digital surgery allows all ancillary personnel to participate fully and may improve patient care.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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