Less cognitive workload required for surgeons using 3D microscope for macular hole surgery

The surgeon’s cognitive workload is markedly reduced while performing macular hole (MH) surgery with a 3D viewing system, according to a recent study. Duration of surgery including internal-limiting membrane (ILM) peel time, MH closure rates, and visual outcomes remains unaffected irrespective of the operating microscope system, the researchers reported.

The study evaluated the cognitive workload using a modern 3D surgical system in comparison to the conventional microscope system. Of the 50 eyes in the study, 30 eyes and 20 eyes underwent surgery with the conventional microscope and the 3D system, respectively. Cognitive workload assessment was performed by real-time tools (surgeons’ heart rate [HR] and oxygen saturation [SPO2]) and self-report tool (Surgery Task Load Index [SURG-TLX] questionnaire) of 3 vitreoretinal surgeons. Based on the questionnaire, an assessment of the workload was conducted.

No difference was noted in the MH basal-diameter, total surgical-duration, ILM peel time, and the final visual acuity (VA) between the 2 groups. Both groups showed significant improvement in VA with a 90% closure rate at 1-month post-surgery. Cognitive workload comparison, the intraoperative HR, total workload score, and temporal-demand dimension were significantly more in conventional microscope group as compared to 3D group. In both the groups, the HR increased significantly from the baseline while performing ILM peeling and at the end.

Reference
Kelkar A, Natarajan S, Kothari A, Bolisetty M. Comparison of cognitive workload and surgical outcomes between a three-dimensional and conventional microscope macular hole surgery. BMC Ophthalmol. 2024;24(1):95. doi:10.1186/s12886-024-03361-5