Heads-up Cataract Surgery: Complication Rates, Surgical Duration, and Comparison With Traditional Microscopes

J Refract Surg. 2019 May 1;35(5):318-322. doi: 10.3928/1081597X-20190410-02.


Purpose: To compare the complication rates and surgical duration between a three-dimensional visualization system (heads-up surgery) and traditional binocular microscope in cataract surgery.

Methods: This retrospective case series included 2,320 eyes that received cataract surgery using either a three-dimensional display system (n = 1,673 eyes) (3D group) or a traditional binocular microscope (n = 647 eyes) (traditional group). The medical records of consecutive patients who underwent cataract surgery by a single surgeon in The Eye Institute of West Florida from August 2016 to July 2017 using either a three-dimensional display system or the traditional binocular microscope for visualization were reviewed. Patients in both groups received either femto-second laser-assisted cataract surgery (FLACS) or traditional phacoemulsification. Complication rate (posterior capsular rapture and vitreous prolapse) and duration of cataract surgery were evaluated.

Results: The 3D group had 12 (0.72%) complications and the traditional group had 5 (0.77%) complications (P > .05). Mean surgical time was 6.48 ± 1.15 minutes for the 3D group and 6.52 ± 1.38 minutes for the traditional group (P > .05). There was no statistically significant difference in complication rate and duration of surgery between the two groups (P > .05).

Conclusions: The implementation of heads-up three-dimensional visualization for cataract surgery seems to offer similar safety and efficiency as the traditional binocular microscope. [J Refract Surg. 2019;35(5):318-322.].

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Female
  • Humans
  • Imaging, Three-Dimensional*
  • Lens Implantation, Intraocular / methods*
  • Male
  • Microscopy / instrumentation*
  • Middle Aged
  • Operating Rooms / statistics & numerical data
  • Operative Time*
  • Phacoemulsification / methods*
  • Postoperative Complications*
  • Retrospective Studies