Eckardt Claus, Paulo Erica B
Department of Ophthalmology, Klinikum Frankfurt Hoechst, Frankfurt, Germany.
Retina. 2016 Jan;36(1):137-47. doi: 10.1097/IAE.0000000000000689.
To investigate the feasibility of performing vitrectomies while viewing a three-dimensional image on a large display in a heads-up position.
Twenty volunteers were compared performing meticulous tasks using the heads-up and the traditional method. Some optical parameters, resolution and depth of field, were measured, and the possibilities of digital image processing were investigated. In addition, routine use of the heads-up method for >400 vitrectomies over 8 months was retrospectively analyzed.
Of note, 91.7% of the volunteers preferred the ergonomics of the heads-up technique. The two methods were judged to be similar regarding speed and ease of microscopic manipulations and sharpness of image. Significantly fewer mistakes were made with the heads-up method. The measured resolution of the eyepieces was approximately twice that of the three-dimensional display, whereas depth of the field was about equal. Electronic amplification of the camera's signal resulted in increased image brightness, allowing use of reduced endoillumination levels. In clinical routine, better ergonomics, digital image processing, and use of a large display are found to be major advantages.
The heads-up method is well suited for vitreoretinal surgery. With further technical improvements, the procedure should soon find widespread use.
研究在平视状态下于大型显示屏上观看三维图像时进行玻璃体切除术的可行性。
对20名志愿者使用平视法和传统方法执行精细任务的情况进行比较。测量了一些光学参数、分辨率和景深，并研究了数字图像处理的可能性。此外，还对8个月内超过400例玻璃体切除术常规使用平视法的情况进行了回顾性分析。
值得注意的是，91.7%的志愿者更喜欢平视技术的人体工程学设计。在速度、显微镜操作的难易程度和图像清晰度方面，两种方法被判定相似。平视法出现的错误明显更少。目镜的测量分辨率约为三维显示屏的两倍，而景深大致相等。相机信号的电子放大提高了图像亮度，从而可以降低眼内照明水平。在临床常规操作中，更好的人体工程学设计、数字图像处理以及大型显示屏的使用被发现是主要优势。
平视法非常适合玻璃体视网膜手术。随着技术的进一步改进，该方法应很快得到广泛应用。
