Heads-Up 3D Surgery under Low Light Intensity Conditions: New High-Sensitivity HD Camera for Ophthalmological Microscopes

Celso Soiti Matsumoto; Masayuki Shibuya; Jun Makita; Takuhei Shoji; Hisato Ohno; Kei Shinoda; Harue Matsumoto

doi:10.1155/2019/5013463

Heads-Up 3D Surgery under Low Light Intensity Conditions: New High-Sensitivity HD Camera for Ophthalmological Microscopes

J Ophthalmol. 2019 Nov 25:2019:5013463. doi: 10.1155/2019/5013463. eCollection 2019.

Authors

Celso Soiti Matsumoto^{1

2

3}, Masayuki Shibuya², Jun Makita², Takuhei Shoji², Hisato Ohno⁴, Kei Shinoda², Harue Matsumoto³

Affiliations

¹ Department of Ophthalmology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-ku, Tokyo 173-8605, Japan.
² Department of Ophthalmology, Saitama Medical University School of Medicine, Morohongo 38, Moroyama-machi, Saitama 350-0495, Japan.
³ Matsumoto Eye Clinic, Tokushima, Japan.
⁴ Ohno Eye Clinic, Saitama, Japan.

Abstract

Purpose: To determine the feasibility of performing intraocular surgeries in a heads-up position with low illuminance conditions by observing a display of the surgical field created by a three-dimensional imaging (3D) system.

Methods: Seventy-four eyes of 56 patients underwent cataract surgery (72 eyes) with the heads-up 3D surgery system; 60 eyes with cataract surgery alone, 7 eyes with combined cataract and glaucoma microdevice implant surgery, 5 eyes with combined cataract and vitrectomy surgery, and two eyes with vitrectomy surgery alone were studied. The illuminance from the surgical microscope was set to be dimmer (Leica M822F40 main light 2%; otto-flex 6%) than the usual setting to minimize the discomfort and glare for the patient. The surgeries were performed under topical anesthesia. The luminance of the images observed through the eyepieces of the operating microscope and the image of a 3D system created by a high-sensitivity sensor Exmor R 3CMOS HD camera (Sony MCC-1000MD) were measured.

Results: All surgeries were completed without any complications under the low illumination conditions. The surgical field on the display monitor was created by a 3D system using a high-sensitivity sensor camera and was observed in a heads-up position. The patients did not report any intolerable discomfort or glare during the surgery. Cataract surgeries were performed with a good view of the surgical field under the extremely low illumination from the surgical microscope. The high-sensitivity sensors and electronic amplifications of the image signals made the surgical field brighter and allowed the surgeon to perform the surgery confidently and safely.

Conclusions: Heads-up, 3D-assisted intraocular surgeries can be performed safely and efficiently with low illuminance of the surgical field. This trial is registered with UMIN000037838.