A comparison of using digitally assisted vitreoretinal surgery during repair of rhegmatogenous retinal detachments to the conventional analog microscope: A prospective interventional study

• Published in: International ophthalmology 2021-05, Vol.41 (5), p.1689-1695
• Main Authors: Kannan, Naresh Babu, Jena, Soumya, Sen, Sagnik, Kohli, Piyush, Ramasamy, Kim
• Format: Article
• Language: English
• Subjects: Acuity; Complications; Eye; Eye (anatomy); Intraocular pressure; Medicine; Medicine & Public Health; Ophthalmology; Original Paper; Retina; Silicones; Surgery; Surgical outcomes; Visual acuity
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-021-01725-0

Background To compare outcomes and complications of pars plana vitrectomy (PPV) using a three-dimensional heads-up visualisation system (digitally assisted vitreoretinal system, DAVS) versus conventional analog microscope (CAM) in primary rhegmatogenous retinal detachment (RRD). Methods This prospective interventional institutional study evaluated 60 eyes of 60 subjects with primary RRD undergoing PPV between September 2017 and February 2018. Subjects were randomly put into DAVS and CAM group and pre-operative ocular characteristics and final outcomes recorded at each visit. All subjects were followed up for a duration of 6 months. Main outcome measures recorded were post-operative retinal status, visual acuity (VA), intraocular pressure (IOP) and surgical complications. Results Overall final retinal attachment at 6 months was 91.7% (90% in DAVS eyes and 93.3% in CAM eyes; p  = 0.999). Final VA improved significantly from baseline in both groups ( p    = 20/40 in 18.3% eyes (6 DAVS, 5 CAM). Median duration of silicone oil endotamponade was 3.5 months (3.5 months in DAVS, 3 months in CAM). Redetachment rate in the series was 25% (20% in DAVS, 30% in CAM). Post-operative proliferative vitreoretinopathy grade C and more was present in 15% of eyes (10% in DAVS, 20% in CAM). Average duration of surgery was 37 ± 6.2 min in DAVS group and 39.8 ± 6.6 min in CAM group ( p  = 0.09). All steps of vitrectomy could be performed with relative ease and comfort with the DAVS platform. Conclusion Anatomical and functional outcomes of RRD were favourable with DAVS and comparable to that with conventional microscope surgery.