Jump to comment:

• Response to: ‘Utility of digitally assisted vitreoretinal surgery systems (DAVS) for high volume vitreoretinal surgery centres: a pilot study’.
  Michael A Mikhail, Mustafa Kadhim, Roxane Hillier, Sandro Di Simplicio and Richard Newsom
  Published on: 5 March 2020

• Published on: 5 March 2020

  Response to: ‘Utility of digitally assisted vitreoretinal surgery systems (DAVS) for high volume vitreoretinal surgery centres: a pilot study’.

  • Michael A Mikhail, Consultant Ophthalmic Surgeon North Cumbria University Hospitals
  • Other Contributors:
    • Mustafa Kadhim, Consultant Ophthalmic Surgeon
    • Roxane Hillier, Consultant Ophthalmic Surgeon
    • Sandro Di Simplicio, Consultant Ophthalmic Surgeon
    • Richard Newsom, Professor of Visual Science

  Dear Sir

  We read with interest Babu’s report on ‘Utility of digitally assisted vitreoretinal surgery systems (DAVS) for high volume vitreoretinal surgery centres: a pilot study’.1 As the first unit in the United Kingdom to purchase and use the NGENUITY 3D Visualization System (Alcon Laboratories, Fort Worth USA), we would like to share our experience. We assessed DAVS against analogue microscope (AM), from the Consultant surgeons’, trainees and the scrub nurses’ perspective. In our group there was a rapid adaption to the altered colours, head position and stereo vision offered by the DAVS for macular disease, with slower uptake for complex retinal detachments and trauma. In particular, we found the view and quality of image colour in macular cases to be sharp, even at high magnification, making for easier and safer membrane peels. DAVS provided a tangibly improved image quality and ease of description and teaching never previously experience by everyone present in theatre. Surgical trainees particularly benefited from better anatomical and a 3D view of the vitreoretinal pathology. Anecdotally, we tend to agree with Babu et al’s findings that the limitations lie in complex anterior segment cases, particularly with a poor red reflex, where we found the view of the posterior capsule to be compromised compared to the AM. Also, the presence of a sizeable disparity in contrast between immediately adjacent structures in the posterior segment (e.g. colobomas, asteroid hyal...

  Show More

  Dear Sir

  We read with interest Babu’s report on ‘Utility of digitally assisted vitreoretinal surgery systems (DAVS) for high volume vitreoretinal surgery centres: a pilot study’.1 As the first unit in the United Kingdom to purchase and use the NGENUITY 3D Visualization System (Alcon Laboratories, Fort Worth USA), we would like to share our experience. We assessed DAVS against analogue microscope (AM), from the Consultant surgeons’, trainees and the scrub nurses’ perspective. In our group there was a rapid adaption to the altered colours, head position and stereo vision offered by the DAVS for macular disease, with slower uptake for complex retinal detachments and trauma. In particular, we found the view and quality of image colour in macular cases to be sharp, even at high magnification, making for easier and safer membrane peels. DAVS provided a tangibly improved image quality and ease of description and teaching never previously experience by everyone present in theatre. Surgical trainees particularly benefited from better anatomical and a 3D view of the vitreoretinal pathology. Anecdotally, we tend to agree with Babu et al’s findings that the limitations lie in complex anterior segment cases, particularly with a poor red reflex, where we found the view of the posterior capsule to be compromised compared to the AM. Also, the presence of a sizeable disparity in contrast between immediately adjacent structures in the posterior segment (e.g. colobomas, asteroid hyalosis) impacted on DAVS image quality. What we were not expecting was the difficulty our scrub nurses would have with the DAVS. They found that the polarised glasses rendered normal stereo vision more difficult, and the tinted lenses were a challenge when working in a dimmed ambient lighting. While the surgeons quickly adapted to the novel viewing system, our nursing colleagues found it less easy to use and took longer to adapt.

  Reference:

  1. Babu N, Kohli P, Jena S, et al. Utility of digitally assisted vitreoretinal surgery systems (DAVS) for high-volume vitreoretinal surgery centre: a pilot study. British Journal of Ophthalmology 2020;104:432-436.

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top