From the Department of Ophthalmology-Retina, Federal University of São Paulo , São Paulo, SP, Brazil.
From the Department of Ophthalmology-Retina, Centre Monticelli Paradis d'Ophtalmologie , Marseille, France.
Curr Eye Res. 2020 Oct;45(10):1265-1272. doi: 10.1080/02713683.2020.1737136. Epub 2020 Mar 9.
: To evaluate the initial experience of four experienced vitreoretinal surgeons, in France, with a three-dimensional (3-D) system, and to explore the potential advantages and disadvantages of this technology. We also report anatomical surgical outcomes of full-thickness idiopathic macular holes (MH) and primary rhegmatogenous retinal detachment (RRD), by using traditional microscopy and heads-up method. : Four French retinal surgeons performed several types of ophthalmic surgeries with this new technology. To compare the 3-D system with ocular viewing, ergonomics, educational value, image sharpness, depth perception, field of view, technical feasibility, advantages and disadvantages, and expectations for the future, were assessed using a questionnaire. We also compared the same questionnaire with the answers of six Brazilian experienced vitreoretinal surgeons. For treating MHs, the surgeons performed 88 surgeries (44 with microscopy and 44 with 3-D). They performed 100 PPV for treating primary RRD (50 with ocular viewing and 50 with 3-D). The visualization method for each patient, as well as the assignment of each surgeon for a specific patient, were all randomly selected. : On the questionnaire, 3-D was preferred to traditional microscopy, except for technical feasibility; the type of surgery benefitting most from the 3-D was macula surgery and the least was anterior segment surgery; the most used by all is the black and white filter in patients with atrophic RPE during ILM peeling. Eighty-one (92.1%) MHs was successfully closed with one surgery and out of the 100 eyes with a primary RRD, the anatomical success after 3 months of follow-up was 91%, with no statistical significance between 3-D and ocular viewing. : The surgeons in this study preferred 3-D to ocular viewing. Vitrectomy surgery to treat MHs and RRDs can be performed using the 3-D with the same efficiency as microscopy. Digital integration of 3-D and iOCT can be useful in some cases. With continuous refinement to improve the ability to visualize inside of the eye, this promising technology may enhance what we do as surgeons.
: 评估四位法国经验丰富的玻璃体视网膜外科医生在三维（3-D）系统方面的初步经验，并探讨该技术的潜在优势和劣势。我们还报告了使用传统显微镜和抬头法治疗全层特发性黄斑裂孔（MH）和原发性孔源性视网膜脱离（RRD）的解剖手术结果。: 四位法国视网膜外科医生使用这项新技术进行了几种眼科手术。为了比较 3-D 系统与眼部观察、人体工程学、教育价值、图像清晰度、深度感知、视野、技术可行性、优缺点以及对未来的期望，使用问卷进行了评估。我们还将该问卷与六位巴西经验丰富的玻璃体视网膜外科医生的答案进行了比较。对于治疗 MH，外科医生进行了 88 例手术（44 例使用显微镜，44 例使用 3-D）。他们对 100 例原发性 RRD 进行了 100 例经玻璃体切除术（50 例眼部观察，50 例 3-D）。每位患者的可视化方法以及每位外科医生为特定患者分配的方法均随机选择。: 在问卷中，除了技术可行性外，3-D 优于传统显微镜；从手术获益最大的是黄斑手术，获益最小的是前段手术；所有外科医生最常使用的是在 RPE 萎缩患者中进行 ILM 剥离时的黑白滤镜。81 例（92.1%）MH 经一次手术成功闭合，在 100 例原发性 RRD 中，3 个月随访后的解剖成功率为 91%，3-D 与眼部观察之间无统计学意义。: 这项研究中的外科医生更喜欢 3-D 而不是眼部观察。使用 3-D 进行玻璃体切割手术治疗 MH 和 RRD 的效率与显微镜相同。3-D 和 iOCT 的数字集成在某些情况下可能会很有用。随着对提高眼内可视化能力的不断改进，这项有前途的技术可能会增强我们作为外科医生的能力。
