Purpose: Macular surgery-related phototoxicity is a topic of increasing concern. In-vivo studies have highlighted a reduction of macular autofluorescence (AF) after acute illumination, even beneath the safety light power threshold. One of the major breakthroughs over the last years in vitreo-retinal surgery is the introduction of three-dimension vision systems (3D); among other advantages, it permits to lower considerably the endoillumination power thanks to digital enhancement of the image. Aim of present study was to investigate the potential benefits on phototoxycity of 3D versus standard two-dimension (2D) vision system. Setting/Venue: Single center study Methods: For 3 months, all pseudophakic patients presenting for epiretinal membrane (EM) surgery were enrolled and randomly allocated 1:1 to 3D group or standard 2D group. In both groups the same surgeon performed 27 Gauge pars plana vitrectomy and EM peeling, setting the lowest endoillumination power compatible with a confortable and safe surgery. All patients underwent SD-OCT and Blue-Light AF at time 1 (T1) 1 hour before surgery, at time 2 (T2) 5 to 15 minutes after surgery and at time 3 (T3) 24 hours after surgery. Results: Eight patients were enrolled for each group. Mean endoillumination power was 10±2.2% and 42±10.5% for 3D and 2D group, respectively (p<0.001). The procedure was successful in all cases for both groups, with no complications. All patients of 3D group showed no differences between T1, T2 and T3 neither for blue AF nor for structural SD-OCT. Conversely, in 2D group 7 patients (87.5%) revealed a decreased autofluorescence in the perifoveal ring at T2 (p<0.001). In all of these 7 cases (100%) there was a complete regression of the phenomenon at T3. Conclusions: Patients treated using the 3D vision system, unlike the ones treated using 2D, reveal no autofluorescence changes in the immediate post-operative time. The present study documents, for the first time, a possible reduction of fototoxicity when using a 3D vision system technology.
Heads up 3d vision system reduces acute phytotoxic related autofluorescence changes after macular surgery / La Spina, Carlo; Del Turco, Claudia; D'Amico Ricci, Giuseppe; Giobbio, Dora; Panico, Claudio. - (2019). ((Intervento presentato al convegno 19 Euretina Congress Paris tenutosi a Parigi nel 5-8 Settembre 2019.