González-Saldivar G, Chow DR. Optimizing Visual Performance With Digitally Assisted Vitreoretinal Surgery.
Ophthalmic Surg Lasers Imaging Retina 2021;
51:S15-S21. [PMID:
32348530 DOI:
10.3928/23258160-20200401-02]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/25/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE
Evaluate depth of field (DOF) and lateral resolution (LR) on digitally assisted vitreoretinal surgery (DAVS) with different camera aperture values and TV viewing distances to determine maximal optical performance.
PATIENTS AND METHODS
Five retinal surgeons objectively evaluated DOF and LR at low (10×), medium (15×), and high (20×) magnification on a conventional microscope (CM) and DAVS. DAVS was evaluated at different camera apertures (30%, 50%, and 75%) and TV viewing distances (1.2 meters [m], 1.5 m, and 2.0 m). A comparison between CM and optimized DAVS values was carried out.
RESULTS
On DAVS, DOF significantly increased as camera aperture size was reduced (75% to 50%, P = .022; 75% to 30%, P ≤ .001; and 50% to 30%, P = .001) and as microscope magnification was reduced (high to medium, P = .009; high to low, P ≤ .001; and medium to low, P = .002). LR significantly increased as microscope magnification was increased (low to medium, P = .010; low to high, P ≤ .001; and medium to high, P = .015) and as TV display distance decreased (2.0 m to 1.5 m, P = .019; 2.0 m to 1.2 m, P = .009; and 1.5 m to1.2 m, P = .185). When comparing optimized DAVS against CM, DOF was significantly larger on DAVS (P = .019). LR on DAVS outperformed the CM, but statistical significant was not reached (P = .185).
CONCLUSIONS
The authors' study is the first to evaluate different aperture, magnification, and TV distance settings, and when optimized, DAVS can significantly outperform a CM with respect to DOF and LR. Optimized visual performance for DAVS is obtained with a 30% camera aperture and a TV viewing distance no further than 1.5 m. Maximal microscope magnification to exploit LR during macular surgery and low-to-medium magnification to increase DOF for overall vitrectomy surgery is recommended. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S15-S21.].
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