gms | German Medical Science

In Heads up surgery the surgeon no longer looks through the microscope oculars as in conventional microsurgical procedures. Instead, the surgeon wears polarizing 3D glasses and sees the surgical field on a large flat screen which displays a high-definition, three-dimensional image from a camera mounted onto the microscope.

For the past three years the author uses the TrueVision System (Santa Barbara, CA) in all cases of his daily schedule including phacoemulsifications, all kinds of vitreoretinal procedures, but also glaucoma and corneal surgeries. Switching from traditional microsurgery to heads up surgery is quick and without problems. Despite the somewhat lower spatial resolution of the 3D image compared to the direct view through the microscope the 3D system allows all surgical manipulations including e.g. ILM removal or DMEK procedures. The impressive stereopsis and sense of depth at high levels of zoom increases the surgical accuracy. Increased brightness of the image can be achieved by digital image processing which offers the opportunity to reduce the intensity of the light source and thus decrease the risk of light toxicity. An additional advantage is the improved ergonomics of the sitting position of the surgeon. In terms of teaching the 3D system is extremely useful. For the first time the teacher and the young surgeon can see the same image.

In conclusion, the 3D system has the potential to have a significant positive impact on ophthalmic surgery. Further benefits, e.g. use of filters or overlays for surgical guidance can be expected.