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比较三维数字化术中 OCT 与玻璃体视网膜手术中常规显微镜集成 OCT:DISCOVER 研究的事后分析。

Comparing Three-Dimensional Digitally Enabled Intraoperative OCT With Conventional Microscope-Integrated OCT in Vitreoretinal Surgery: A Post Hoc Analysis of the DISCOVER Study.

出版信息

Ophthalmic Surg Lasers Imaging Retina. 2024 May;55(5):270-277. doi: 10.3928/23258160-20240206-01. Epub 2024 Mar 1.

DOI:10.3928/23258160-20240206-01
PMID:38648428
Abstract

BACKGROUND AND OBJECTIVE

This study compared the surgeon experience between conventional microscope-integrated intraoperative optical coherence tomography (iOCT) and digitally enabled microscope-integrated iOCT in vitreoretinal surgery.

PATIENTS AND METHODS

This is a post hoc case-control analysis of the DISCOVER study. Conventional microscope-integrated iOCT (Rescan 700, Zeiss) was compared with digitally enabled iOCT (Artevo 800, Zeiss). Compared variables included surgical field-based visualization (ie, ocular heads-up display in the conventional group; three-dimensional screen-based visualization in the digital iOCT group) and non-surgical field-based visualization (ie, review on the external two-dimensional monitor).

RESULTS

A total of 200 patients were included. Surgical field-based visualization of iOCT was significantly higher in the digitally enabled group ( < 0.0001). Required endoillumination level was significantly lower in the digital iOCT group ( < 0.0001). Surgeons reported "significant" back discomfort and headache more frequently when using conventional iOCT ( = 0.003 and = 0.001, respectively).

CONCLUSIONS

Digitally enabled iOCT resulted in greater surgical visualization efficiency, appeared to require a lower illumination level, and may provide advantages for ergonomic-related discomfort. .

摘要

背景与目的

本研究比较了传统显微镜整合术中光学相干断层扫描(iOCT)与数字化显微镜整合 iOCT 在玻璃体视网膜手术中的外科医生经验。

患者与方法

这是 DISCOVER 研究的事后病例对照分析。将传统显微镜整合 iOCT(Rescan 700,蔡司)与数字化 iOCT(Artevo 800,蔡司)进行比较。比较的变量包括手术场基于可视化(即常规组中的眼部抬头显示;数字 iOCT 组中的三维屏幕基于可视化)和非手术场基于可视化(即外部二维监视器上的复查)。

结果

共纳入 200 例患者。数字化组的 iOCT 手术场基于可视化显著更高(<0.0001)。数字 iOCT 组的内照明水平显著降低(<0.0001)。使用传统 iOCT 时,外科医生报告“显著”背部不适和头痛的频率更高(=0.003 和=0.001,分别)。

结论

数字化 iOCT 可提高手术可视化效率,似乎需要较低的照明水平,并且可能在与人体工程学相关的不适方面具有优势。

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