三维数字辅助视觉系统与常规显微镜在黄斑手术中视网膜危害的评价。

Yuka Horigome, Yume Iwashita, Kazushi Hirono, Tatsuya Inoue, Ami Konno, Kazuaki Kadonosono, Yasuo Yanagi
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引用次数: 1

摘要

目的:利用数字三维可视化系统(3D)和常规显微镜(CM)研究黄斑手术中视网膜的光危害。设计:实验研究和病例对照研究的回顾性评价。对象:分别采用3D和CM技术行视网膜前膜玻璃体切除20例和10例。方法:在玻璃体核心切除术和3D和CM操作黄斑时,测量了代表性设置的内照器的光谱辐照度。从患者的病历中提取出玻璃体核心切除术和黄斑操作所需的时间。根据光谱辐照度加权标准函数计算视网膜总光危害指数和黄斑危害指数。比较两组患者视网膜总光危害指数、黄斑危害指数及超过最大允许辐射功率暴露的病例数。结果:在典型设置下,3D组和cm组的光谱辐照度分别为1.6和3.9 mW/ cm2,黄斑操作组的光谱辐照度分别为3.4和8.1 mW/ cm2。视网膜总光危害指数3D组为4.31 ~ 17.37 kJ/ m2, CM组为11.09 ~ 27.70 kJ/ m2,黄斑光危害指数3D组为2.93 ~ 14.58 kJ/ m2, CM组为6.84 ~ 23.55 kJ/ m2 (P < 0.001)。3D组和CM组分别有1例(5%)和6例(60%)玻璃体切割超过阈值(P < 0.05,卡方检验)。结论:考虑到潜在的视网膜危害,与CM相比,3D数字辅助可视化系统提供了更安全的黄斑手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
EVALUATION OF THE RETINAL HAZARD WITH 3D DIGITALLY ASSISTED VISUALIZATION SYSTEM AND CONVENTIONAL MICROSCOPE IN MACULAR SURGERIES.

Purpose: To investigate the retinal light hazard during macular surgery using a digital three-dimensional visualization system (3D) and a conventional microscope (CM).

Design: Experimental study and retrospective evaluation of a case-control study.

Subjects: A total of 20 and 10 patients who underwent pars plana vitrectomy for epiretinal membrane using 3D and CM, respectively.

Methods: Spectral irradiances of endoilluminators were measured for representative settings used during core vitrectomy and macular manipulations with 3D and CM. From the medical record of the patients, time needed for core vitrectomy and macular manipulations was extracted. The total retinal light hazard index and the macular hazard index were calculated based on the spectral irradiances weighted by the standard functions. Total retinal light hazard index, macular hazard index, and the number of cases that exceeded the maximum permissible radiant power exposure were compared between the two groups.

Results: The spectral irradiance were 1.6 and 3.9 mW/cm 2 for core vitrectomy and 3.4 and 8.1 mW/cm 2 for macular manipulations using typical settings for 3D and CM groups, respectively. The total retinal light hazard index ranged from 4.31 kJ/m 2 to 17.37 kJ/m 2 for 3D and 11.09 kJ/m 2 to 27.70 kJ/m 2 for CM groups, respectively, whereas the macular hazard index ranged from 2.93 kJ/m 2 to 14.58 kJ/m 2 for 3D and from 6.84 kJ/m 2 to 23.55 kJ/m 2 for CM, respectively ( P < 0.001). One (5%) and 6 (60%) pars plana vitrectomy cases exceeded the threshold limits with 3D and CM groups, respectively ( P < 0.05, chi-square test).

Conclusion: The 3D digitally assisted visualization system offers significantly safer macular surgery compared with the CM, considering the potential retinal hazard.

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