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Freeman, William R., MD*,†; Chen, Kevin C., MD*,†; Ho, Joseph, MD*,†; Chao, Daniel L., MD, PhD*,†; Ferreyra, Henry A., MD*,†; Tripathi, A. Burton, PhD; Nudleman, Eric, MD, PhD*,†; Bartsch, Dirk-Uwe, PhD*,†

doi: 10.1097/IAE.0000000000002236
Original Study: PDF Only

Purpose: To evaluate depth of field, lateral resolution, and image quality of a heads-up 3D visualization system for vitreoretinal surgery using physician survey and optical measurement outcomes.

Methods: Depth of field and lateral resolution were compared between the standard ocular viewing system and the digital 3D system at ×5, ×13, and ×18 magnification by 6 retinal surgeons. Optical techniques were used as well as a survey of surgeon impression. Surgeon impression surveys were performed after 6 weeks of surgical use of the device.

Results: Physician questionnaire survey scores for depth of field at high magnification were better for the digital 3D system and equivalent for all other categories. Measured lateral resolution was 36.7 mm and 16.6 mm at ×5 magnification (P < 0.001), 14.3 mm and 6.4 mm at ×13 magnification (P < 0.001), and 9.8 mm and 4.2 mm (P < 0.001) at ×18 magnification for the digital 3D and oculars, respectively. Measured depth of field was 4.00 mm and 6.78 mm at ×5 magnification (P = 0.027), 0.72 mm and 0.86 mm at ×13 (P = 0.311), and 0.28 mm and 0.40 mm at ×18 magnification (P = 0.235) for the oculars and digital 3D, respectively.

Conclusion: Lateral resolution of the digital 3D system was half that of the ocular viewing system and there was some improvement in depth of field with the digital system. Surgeon impression suggested that the digital system was superior when evaluating depth of field at high magnification.

The resolution of the digitally assisted imaging system is roughly half that of the standard operating microscope, whereas the depth of field is similar. Survey scores for depth of field at high magnification were better with the digitally assisted system.

*Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California;

Jacobs Retina Center, University of California San Diego, La Jolla, California; and

TrueVision 3D Surgical, Santa Barbara, California.

Reprint requests: William R. Freeman, MD, Shiley Eye Institute, 9415 Campus Point Drive, #0946, La Jolla, CA 92093; e-mail:

None of the authors has any financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.