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Abstract：
Purpose: To assess the efficacy and outcomes of 23-gauge vitreoretinal surgery for rhegmatogenous retinal detachment using a three-dimensional heads-up display (3D HUD) surgical platform as compared to a standard operating microscope (SOM) setting. Design: Retrospective cohort study. Participants: One hundred and forty consecutive eyes of 140 patients with primary retinal detachment. Methods: All eyes underwent 23-gauge pars plana vitrectomy for primary retinal detachment using either a 3D HUD (NGENUITY; Alcon Inc., Fort Worth, Texas, USA; n = 70 eyes) or a SOM setting (n = 70 eyes); in cases of significant cataract, additional phacoemulsification with intraocular lens (IOL) implantation was performed. Minimum follow-up was 2 months. Main Outcome Measures: Primary retinal reattachment rate, rate of proliferative vitreoretinopathy (PVR), best-corrected visual acuity (BCVA), and duration of surgery. Results: There were 70 eyes each in the 3D HUD and the SOM group. Both groups did not differ concerning age (p = 0.70), extent of retinal detachment (p = 0.07), number of retinal tears (p = 0.40), macular involvement (p = 0.99), and preoperative BCVA (p = 0.99). Postoperatively, 3D HUD and SOM were comparable concerning the primary retinal reattachment rate (88.6 vs. 94.3%; p = 0.37), the development of postoperative PVR (12.9% vs. 7.1%; p = 0.40) and final BCVA (0.26 ± 0.40 vs. 0.21 ± 0.38 logMAR; p = 0.99). Duration of surgery was significantly longer in the 3D HUD group (66.2 ± 16.5 vs. 61.2 ± 17.1 min; p = 0.04), an effect which however vanished after a \"learning curve\" of the first 35 eyes (p = 0.49). Conclusions: On par results to a conventional operating microscope can be achieved with a 3D HUD setting when performing 23-gauge vitreoretinal surgery for rhegmatogenous retinal detachment, including the primary retinal reattachment rate, the incidence of postoperative PVR and final BCVA. However, duration of surgery might initially be slightly longer with 3D HUD, suggesting the effect of a learning curve.
摘要：
目的：与标准手术显微镜（SOM）设置相比，使用三维平视显示器（3DHUD）手术平台评估23号玻璃体视网膜手术治疗孔源性视网膜脱离的疗效和结果。设计：回顾性队列研究。参与者：140例原发性视网膜脱离患者的一百四十只眼。方法：使用3DHUD对所有眼睛进行了23号平面玻璃体切除术，以进行原发性视网膜脱离（NGENUITY；AlconInc.，沃思堡,德州,美国；n=70眼）或SOM设置（n=70眼）；在严重白内障的情况下，进行了额外的白内障超声乳化吸除联合人工晶状体(IOL)植入.最少随访2个月。主要指标：原发性视网膜复位率，增生性玻璃体视网膜病变（PVR）的发生率，最佳矫正视力（BCVA），和手术持续时间。结果：3DHUD和SOM组各70只眼。两组在年龄方面没有差异（p=0.70），视网膜脱离程度（p=0.07），视网膜撕裂的数量（p=0.40），黄斑受累（p=0.99），术前BCVA(p=0.99)。术后,3DHUD和SOM在原发性视网膜复位率方面具有可比性（88.6vs.94.3%；p=0.37），术后PVR的发展(12.9%vs.7.1％；p=0.40）和最终BCVA（0.26±0.40vs.0.21±0.38logMAR；p=0.99）。3DHUD组的手术持续时间明显更长（66.2±16.5vs.61.2±17.1分钟；p=0.04），然而，在前35只眼睛的“学习曲线”(p=0.49)后，这种效应消失了。结论：在进行23号玻璃体视网膜手术治疗孔源性视网膜脱离时，使用3DHUD设置可以获得与常规手术显微镜相同的结果，包括原发性视网膜复位率，术后PVR和最终BCVA的发生率。然而,手术的持续时间最初可能会稍长一些3DHUD，表明学习曲线的效果。
