American journal of ophthalmology · 2025
Overcoming Corneal Opacity Challenges: Visualization Assessment of 3D System With Coaxial Illumination in Cataract Surgery.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Wang Yan, Hu Yingfeng, Wang Daoguang, Zhang Rong, Wang Zheng, Zhang Guangbin, Huang Jinling, Ye Xiangyu
Аннотация
PURPOSE: To evaluate the performance of the 3D visualization system with coaxial illumination (3D-C) in treating cataract patients with corneal opacities.
DESIGN: Prospective, comparative interventional case series.
SUBJECTS: This study included patients with cataract and corneal opacities that underwent phacoemulsification.
INCLUSION CRITERIA: senile cataract cases with stable corneal opacity of grade 2-3 (Corneal Haze classification).
EXCLUSION CRITERIA: (1) prior intraocular surgical interventions excluding corneal procedures; (2) ocular complications such as active corneal infections, glaucoma, lens dislocation, vitreoretinal diseases, or uveitis.
METHODS: This two-part assessment for visualization comprised of an objective analysis utilizing surgical video images and a subjective survey collecting feedback from the surgeons. Data of each eye were obtained with 2 approaches: 3D visualization system with coaxial illumination (3D-C) and 3D visualization system with standard illumination (3D-S).
MAIN OUTCOME MEASURES: Objective analysis: red reflex and contrast assessment of images in the followed steps: before the surgery, capsulorhexis, nucleus groove, and cortex aspiration. Subjective survey: scales from five experienced surgeons at eight parameters: red reflex, depth of field, corneoscleral limbus clarity, capsulorhexis, hydrodissection, nucleus groove, cortex removal, and ophthalmic viscosurgical devices removal.
RESULTS: The red reflex values of the 3D-C group were 207.7 ± 26.2, 195.7 ± 24.6, 154.3 ± 18.6, and 179.7 ± 21.6 in the steps of surgery beginning, capsulorhexis, nucleus groove, and cortex aspiration, which were markedly greater than those of the 3D-S group (P ≤ .001). Contrast values of the aforementioned steps were higher in the 3D-C group than in the 3D-S group (P ≤ .01). All surgeons emphasized that the intraocular tissue below corneal opacity was more clearly identified during various stages of the surgery by intensifying intraoperative visualization through the 3D-C approach.
CONCLUSIONS: The 3D-C approach significantly enhanced red reflex and contrast within the pupillary area during phacoemulsification. The utilization of the 3D-C approach is beneficial for performing surgical maneuvers in cataract patients with corneal opacities.
DESIGN: Prospective, comparative interventional case series.
SUBJECTS: This study included patients with cataract and corneal opacities that underwent phacoemulsification.
INCLUSION CRITERIA: senile cataract cases with stable corneal opacity of grade 2-3 (Corneal Haze classification).
EXCLUSION CRITERIA: (1) prior intraocular surgical interventions excluding corneal procedures; (2) ocular complications such as active corneal infections, glaucoma, lens dislocation, vitreoretinal diseases, or uveitis.
METHODS: This two-part assessment for visualization comprised of an objective analysis utilizing surgical video images and a subjective survey collecting feedback from the surgeons. Data of each eye were obtained with 2 approaches: 3D visualization system with coaxial illumination (3D-C) and 3D visualization system with standard illumination (3D-S).
MAIN OUTCOME MEASURES: Objective analysis: red reflex and contrast assessment of images in the followed steps: before the surgery, capsulorhexis, nucleus groove, and cortex aspiration. Subjective survey: scales from five experienced surgeons at eight parameters: red reflex, depth of field, corneoscleral limbus clarity, capsulorhexis, hydrodissection, nucleus groove, cortex removal, and ophthalmic viscosurgical devices removal.
RESULTS: The red reflex values of the 3D-C group were 207.7 ± 26.2, 195.7 ± 24.6, 154.3 ± 18.6, and 179.7 ± 21.6 in the steps of surgery beginning, capsulorhexis, nucleus groove, and cortex aspiration, which were markedly greater than those of the 3D-S group (P ≤ .001). Contrast values of the aforementioned steps were higher in the 3D-C group than in the 3D-S group (P ≤ .01). All surgeons emphasized that the intraocular tissue below corneal opacity was more clearly identified during various stages of the surgery by intensifying intraoperative visualization through the 3D-C approach.
CONCLUSIONS: The 3D-C approach significantly enhanced red reflex and contrast within the pupillary area during phacoemulsification. The utilization of the 3D-C approach is beneficial for performing surgical maneuvers in cataract patients with corneal opacities.