The application and perspectives of 3D heads-up display viewing system in vitreoretinal surgery_Chinese Journal of Ocular Fundus Diseases

Authors：

 Xu Gezhi , Tang Wenyi

Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China;

Corresponding author：

Xu Gezhi, Email: drxugezhi@163.com

Keywords：

Retinal diseases/surgery; Vitreoretinal surgery; Ophthalmology/trends; Editorial; 3D heads-up display viewing system

DOI：

10.3760/cma.j.issn.1005-1015.2019.06.001

Video：

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There has been ongoing progress in the new technique and equipment in vitreoretinal surgery in recent years, contributing to the improvement of treatment of various vitreoretinal diseases. The application of 3D heads-up display viewing system (3D viewing system) has been one of the most fascinating breakthroughs in vitreoretinal surgery. Unlike the traditional method in which the surgeons have to look through the microscope eyepieces, this system allows them to turn their heads up and operate with their eyes on a high-definition 3D monitor. It provides the surgeons with superior visualization and stereoscopic sensation. And increasing studies have revealed it to be as safe and effective as the traditional microscopic system. Furthermore, the surgeons can keep a heads-up position in a more comfortable posture and lesson the pressure on cervical spine. Meanwhile, 3D viewing system makes it easier for the teaching and learning process among surgeons and assistants. However, there are still potential disadvantages including the latency between surgeon maneuver and visualization on the display, learning curves and cost. We hope that the 3D viewing system will be widely used and become a useful new tool for various vitreoretinal diseases in the near future with rapid development in the technology and constant upgrade of the system.

Citation： Xu Gezhi, Tang Wenyi. The application and perspectives of 3D heads-up display viewing system in vitreoretinal surgery. Chinese Journal of Ocular Fundus Diseases, 2019, 35(6): 525-528. doi: 10.3760/cma.j.issn.1005-1015.2019.06.001 Copy

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2.	Riemann CD. Vision and vitrectomy three-dimensional high definition (3DHD) video for surgical visualization in the retina OR[C]. American Academy of Ophthalmology, Chicago, IL, US, 2010.
3.	Eckardt C, Paulo EB. Heads-up surgery for vitreoretinal procedures: an experimental and clinical study[J]. Retina, 2016, 36(1): 137-147. DOI: 10.1097/IAE.0000000000000689.
4.	Freeman WR, Chen KC, Ho J, et al. Resolution, depth of field, and physician satisfaction during digitally assisted vitreoretinal surgery[J]. Retina, 2019, 39(9): 1768-1771. DOI: 10.1097/IAE.0000000000002236.
5.	Coppola M, La Spina C, Rabiolo A, et al. Heads-up 3D vision system for retinal detachment surgery[J]. Int J Retina Vitreous, 2017, 3: 46. DOI: 10.1186/s40942-017-0099-2.
6.	Romano MR, Cennamo G, Comune C, et al. Evaluation of 3D heads-up vitrectomy: outcomes of psychometric skills testing and surgeon satisfaction[J]. Eye (Lond), 2018, 32(6): 1093-1098. DOI: 10.1038/s41433-018-0027-1.
7.	Kunikata H, Abe T, Nakazawa T. Heads-up macular surgery with a 27-gauge microincision vitrectomy system and minimal illumination[J]. Case Rep Ophthalmol, 2016, 7(3): 265-269. DOI: 10.1159/000452993.
8.	Talcott KE, Adam MK, Sioufi K, et al. Comparison of a three-dimensional heads-up display surgical platform with a standard operating microscope for macular surgery[J]. Ophthalmol Retina, 2019, 3(3): 244-251. DOI: 10.1016/j.oret.2018.10.016.
9.	Zhang T, Tang W, Xu G. Comparative analysis of three-dimensional heads-up vitrectomy and traditional microscopic vitrectomy for vitreoretinal diseases[J]. Curr Eye Res, 2019, 44(10): 1080-1086. DOI: 10.1080/02713683.2019.1612443.
10.	Zhang Z, Wang L, Wei Y, et al. The preliminary experiences with three-dimensional heads-up display viewing system for vitreoretinal surgery under various status[J]. Curr Eye Res, 2019, 44(1): 102-109. DOI: 10.1080/02713683.2018.1526305.
11.	Palacios RM, de Carvalho ACM, Maia M, et al. An experimental and clinical study on the initial experiences of Brazilian vitreoretinal surgeons with heads-up surgery[J]. Graefe’s Arch Clin Exp Ophthalmol, 2019, 257(3): 473-483. DOI: 10.1007/s00417-019-04246-w.
12.	Charles S, Dugel PU, Packo KH. Innovation in retina surgery[J]. Eurotimes, 2018, 23(3): 4-5.
13.	Berrocal M, Figueroa M, Packo KH. A new way to see the big picture in a microenvironment[J]. Insert to Retina Today, 2016, 3: 4-7.
14.	Adam MK, Thornton S, Regillo CD, et al. Minimal endoillumination levels and display luminous emittance during three-dimensional heads-up vitreoretinal surgery[J]. Retina, 2017, 37(9): 1746-1749. DOI: 10.1097/IAE.0000000000001420.
15.	Williams GA. Surgical viewing: do you see what I see?[J]. Retina, 2017, 37(7): 1219. DOI: 10.1097/IAE.0000000000001721.
16.	Read SP, Fortun JA. Visualization of the retina and vitreous during vitreoretinal surgery: new technologies[J]. Curr Opin Ophthalmol, 2017, 28(3): 238-241. DOI: 10.1097/ICU.0000000000000368.
17.	Kumar A, Hasan N, Kakkar P, et al. Comparison of clinical outcomes between "heads-up" 3D viewing system and conventional microscope in macular hole surgeries: a pilot study[J]. Indian J Ophthalmol, 2018, 66(12): 1816-1819. DOI: 10.4103/ijo.IJO_59_18.
18.	Rizzo S, Abbruzzese G, Savastano A, et al. 3D surgical viewing system in ophthalmology: perceptions of the surgical team[J]. Retina, 2018, 38(4): 857-861. DOI: 10.1097/IAE.0000000000002018.
19.	Chhaya N, Helmy O, Piri N, et al. Comparison of 2D and 3D video displays for teaching vitreoretinal surgery[J]. Retina, 2018, 38(8): 1556-1561. DOI: 10.1097/IAE.0000000000001743.

1. Weinstock R, Donnenfeld, ED. 3D visualization in ophthalmology[EB/OL]. Cataract Refract Surg Today, 2008: 62-65. https://crstoday.com/articles/2008-may/crst0508_16-php/.
2. Riemann CD. Vision and vitrectomy three-dimensional high definition (3DHD) video for surgical visualization in the retina OR[C]. American Academy of Ophthalmology, Chicago, IL, US, 2010.
3. Eckardt C, Paulo EB. Heads-up surgery for vitreoretinal procedures: an experimental and clinical study[J]. Retina, 2016, 36(1): 137-147. DOI: 10.1097/IAE.0000000000000689.
4. Freeman WR, Chen KC, Ho J, et al. Resolution, depth of field, and physician satisfaction during digitally assisted vitreoretinal surgery[J]. Retina, 2019, 39(9): 1768-1771. DOI: 10.1097/IAE.0000000000002236.
5. Coppola M, La Spina C, Rabiolo A, et al. Heads-up 3D vision system for retinal detachment surgery[J]. Int J Retina Vitreous, 2017, 3: 46. DOI: 10.1186/s40942-017-0099-2.
6. Romano MR, Cennamo G, Comune C, et al. Evaluation of 3D heads-up vitrectomy: outcomes of psychometric skills testing and surgeon satisfaction[J]. Eye (Lond), 2018, 32(6): 1093-1098. DOI: 10.1038/s41433-018-0027-1.
7. Kunikata H, Abe T, Nakazawa T. Heads-up macular surgery with a 27-gauge microincision vitrectomy system and minimal illumination[J]. Case Rep Ophthalmol, 2016, 7(3): 265-269. DOI: 10.1159/000452993.
8. Talcott KE, Adam MK, Sioufi K, et al. Comparison of a three-dimensional heads-up display surgical platform with a standard operating microscope for macular surgery[J]. Ophthalmol Retina, 2019, 3(3): 244-251. DOI: 10.1016/j.oret.2018.10.016.
9. Zhang T, Tang W, Xu G. Comparative analysis of three-dimensional heads-up vitrectomy and traditional microscopic vitrectomy for vitreoretinal diseases[J]. Curr Eye Res, 2019, 44(10): 1080-1086. DOI: 10.1080/02713683.2019.1612443.
10. Zhang Z, Wang L, Wei Y, et al. The preliminary experiences with three-dimensional heads-up display viewing system for vitreoretinal surgery under various status[J]. Curr Eye Res, 2019, 44(1): 102-109. DOI: 10.1080/02713683.2018.1526305.
11. Palacios RM, de Carvalho ACM, Maia M, et al. An experimental and clinical study on the initial experiences of Brazilian vitreoretinal surgeons with heads-up surgery[J]. Graefe’s Arch Clin Exp Ophthalmol, 2019, 257(3): 473-483. DOI: 10.1007/s00417-019-04246-w.
12. Charles S, Dugel PU, Packo KH. Innovation in retina surgery[J]. Eurotimes, 2018, 23(3): 4-5.
13. Berrocal M, Figueroa M, Packo KH. A new way to see the big picture in a microenvironment[J]. Insert to Retina Today, 2016, 3: 4-7.
14. Adam MK, Thornton S, Regillo CD, et al. Minimal endoillumination levels and display luminous emittance during three-dimensional heads-up vitreoretinal surgery[J]. Retina, 2017, 37(9): 1746-1749. DOI: 10.1097/IAE.0000000000001420.
15. Williams GA. Surgical viewing: do you see what I see?[J]. Retina, 2017, 37(7): 1219. DOI: 10.1097/IAE.0000000000001721.
16. Read SP, Fortun JA. Visualization of the retina and vitreous during vitreoretinal surgery: new technologies[J]. Curr Opin Ophthalmol, 2017, 28(3): 238-241. DOI: 10.1097/ICU.0000000000000368.
17. Kumar A, Hasan N, Kakkar P, et al. Comparison of clinical outcomes between "heads-up" 3D viewing system and conventional microscope in macular hole surgeries: a pilot study[J]. Indian J Ophthalmol, 2018, 66(12): 1816-1819. DOI: 10.4103/ijo.IJO_59_18.
18. Rizzo S, Abbruzzese G, Savastano A, et al. 3D surgical viewing system in ophthalmology: perceptions of the surgical team[J]. Retina, 2018, 38(4): 857-861. DOI: 10.1097/IAE.0000000000002018.
19. Chhaya N, Helmy O, Piri N, et al. Comparison of 2D and 3D video displays for teaching vitreoretinal surgery[J]. Retina, 2018, 38(8): 1556-1561. DOI: 10.1097/IAE.0000000000001743.

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Chinese Journal of Ocular Fundus Diseases

The application and perspectives of 3D heads-up display viewing system in vitreoretinal surgery

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