Skip to main content

Advertisement

SpringerLink
Log in

A comparison of using digitally assisted vitreoretinal surgery during repair of rhegmatogenous retinal detachments to the conventional analog microscope: A prospective interventional study

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To compare outcomes and complications of pars plana vitrectomy (PPV) using a three-dimensional heads-up visualisation system (digitally assisted vitreoretinal system, DAVS) versus conventional analog microscope (CAM) in primary rhegmatogenous retinal detachment (RRD).

Methods

This prospective interventional institutional study evaluated 60 eyes of 60 subjects with primary RRD undergoing PPV between September 2017 and February 2018. Subjects were randomly put into DAVS and CAM group and pre-operative ocular characteristics and final outcomes recorded at each visit. All subjects were followed up for a duration of 6 months. Main outcome measures recorded were post-operative retinal status, visual acuity (VA), intraocular pressure (IOP) and surgical complications.

Results

Overall final retinal attachment at 6 months was 91.7% (90% in DAVS eyes and 93.3% in CAM eyes; p = 0.999). Final VA improved significantly from baseline in both groups (p < 0.001). Overall, VA improved to >  = 20/40 in 18.3% eyes (6 DAVS, 5 CAM). Median duration of silicone oil endotamponade was 3.5 months (3.5 months in DAVS, 3 months in CAM). Redetachment rate in the series was 25% (20% in DAVS, 30% in CAM). Post-operative proliferative vitreoretinopathy grade C and more was present in 15% of eyes (10% in DAVS, 20% in CAM). Average duration of surgery was 37 ± 6.2 min in DAVS group and 39.8 ± 6.6 min in CAM group (p = 0.09). All steps of vitrectomy could be performed with relative ease and comfort with the DAVS platform.

Conclusion

Anatomical and functional outcomes of RRD were favourable with DAVS and comparable to that with conventional microscope surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Data are available with the corresponding author on request.

References

  1. Eckardt C, Paulo EB (2016) Heads-up surgery for vitreoretinal procedures: An experimental and clinical study. Retina 36:137–147

    Article  Google Scholar 

  2. Romano MR, Cennamo G, Comune C et al (2018) Evaluation of 3D heads-up vitrectomy: outcomes of psychometric skills testing and surgeon satisfaction. Eye 32:1093–1098

    Article  Google Scholar 

  3. Coppola M, La Spina C, Rabiolo A et al (2017) Heads-up 3D vision system for retinal detachment surgery. Int J Retina Vitreous 3:46

    Article  Google Scholar 

  4. Babu N, Kohli P, Ramachandran O, Ramasamy K (2018) Comparison of Surgical Performance of Internal Limiting Membrane Peeling Using a 3-D Visualization System With Conventional Microscope. Ophthalmic Surg Las Imag Retina 49:941–945

    Article  Google Scholar 

  5. Machemer R, Aaberg TM, Freeman HM et al (1991) An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol 112:159–165

    Article  CAS  Google Scholar 

  6. Levy ML, Day JD, Albuquerque F et al (1997) Heads-up intraoperative endoscopic imaging: a prospective evaluation of techniques and limitations. Neurosurgery 40:526–530

    CAS  PubMed  Google Scholar 

  7. Weinstock RJ, Donnenfeld ED (2008). 3D visualization in ophthalmology. Cat Refract Surg Tod :62–65

  8. Riemann CD (2010) Vision and vitrectomy—three dimensional high definition (3DHD) video for surgical visualization in the retina. American Academy of Ophthalmology; October; Chicago, IL, Paper presented at

    Google Scholar 

  9. Riemann CD. Machine vision and vitrectomy: three-dimensional high definition (3DHD) video for surgical visualization in vitreoretinal surgery, Proc. SPIE 7863, Stereoscopic Displays and Applications XXII, 78630K

  10. Lai C-T, Kung W-H, Lin C-J, Chen H-S, Bair H, Lin J-M et al (2019) Outcome of primary rhegmatogenous retinal detachment using microincision vitrectomy and sutureless wide-angle viewing systems. BMC Ophthalmology. 19:230

    Article  Google Scholar 

  11. Talcott KE, Obeid A, Gao X, Adika A, Regillo CD (2019) Pars Plana Vitrectomy Alone for Primary Rhegmatogenous Retinal Detachments Associated With Inferior Breaks in Phakic Eyes. Ophthalmic Surg Lasers Imaging Retina 50:153–158

    Article  Google Scholar 

  12. Dell’Omo R, Barca F, Tan HS, Bijl HM, Oberstein SY et al (2013) Parsplana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system. Graefes Arch Clin Exp Ophthalmol 251:485–490

    Article  Google Scholar 

  13. Colyer MH, Barazi MK, von Fricken MA (2010) Retrospective comparison of 25-gauge transconjunctival sutureless vitrectomy to 20-gauge vitrectomy for the repair of pseudophakic primary inferior rhegmatogenous retinal detachment. Retina 30:1678–1684

    Article  Google Scholar 

  14. Bourla DH, Bor E, Axer-Siegel R, Mimouni K, Weinberger D (2010) Outcomes and complications of rhegmatogenous retinal detachment repair with selective sutureless 25-gauge pars plana vitrectomy. Am JOphthalmol 149:630–634

    Article  Google Scholar 

  15. Kunikata H, Nishida K (2010) Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment; 84 consecutive cases. Eye (Lond) 24:1071–1077

    Article  CAS  Google Scholar 

  16. Von Fricken MA, Kunjukunju N, Weber C, Ko G (2009) 25-Gaugesutureless vitrectomy versus 20-gauge vitrectomy for the repair of primary rhegmatogenous retinal detachment. Retina 29:444–450

    Article  Google Scholar 

  17. Lai MM, Ruby AJ, Sarrafizadeh R, Urban KE, Hassan TS et al (2008) Repair of primary rhegmatogenous retinal detachment using 25-gaugetransconjunctival sutureless vitrectomy. Retina 28:729–734

    Article  Google Scholar 

  18. Kapran Z, Acar N, Altan T, Unver YB, Yurttaser S (2009) 25-Gaugesutureless vitrectomy with oblique sclerotomies for the management of retinal detachment in pseudophakic and phakic eyes. Eur J Ophthalmol 19:853–860

    Article  Google Scholar 

  19. Kita M, Mori Y, Hama S (2018) Hybrid wide-angle viewing-endoscopic vitrectomy using a 3D visualization system. Clin Ophthalmol 12:313

    Article  Google Scholar 

  20. Halberstadt M, Chatterjee-Sanz N, Brandenberg L, Koerner-Stiefbold U, Koerner F, Garweg JG (2005) Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes. Eye 19:891–898

    Article  CAS  Google Scholar 

  21. Palácios RM, de Carvalho ACM, Maia M, Caiado RR, Camilo DAG, Farah ME (2019) An experimental and clinical study on the initial experience of Brazilian vitreoretinal surgeons with heads-up surgery. Graefes Arch Clin Exp Ophthalmol 257:473–483

    Article  Google Scholar 

Download references

Funding

NO funds were obtained separately for this study.

Author information

Authors and Affiliations

  1. Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India

    Naresh Babu Kannan, Soumya Jena, Sagnik Sen, Piyush Kohli & Kim Ramasamy

Authors
  1. Naresh Babu Kannan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Soumya Jena
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sagnik Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Piyush Kohli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kim Ramasamy
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NBK was involved in concept design and final approval; SJ was involved in concept design, data collection and analysis, and final approval; SS was involved in data collection and analysis, drafting manuscript, and final approval; PK was involved in data collection and final approval; KR was involved in final approval.

Corresponding author

Correspondence to Sagnik Sen.

Ethics declarations

Conflict of interest

None of the authors declares that he has any conflict of interest.

Consent to participants

Informed consent was obtained from all individual participants included in the study at the time of their treatments performed.

Consent to publication

Informed consent for potential research publication was obtained from all individual participants included in the study at the time of their treatments performed.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (Aravind Eye Hospital Institutional Research Committee, RET201900217).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kannan, N.B., Jena, S., Sen, S. et al. A comparison of using digitally assisted vitreoretinal surgery during repair of rhegmatogenous retinal detachments to the conventional analog microscope: A prospective interventional study. Int Ophthalmol 41, 1689–1695 (2021). https://doi.org/10.1007/s10792-021-01725-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-021-01725-0

Keywords

Search

Navigation