Comparison of 3d digitally assisted visualization system with current standard visualization for the removal of vitreous in a preclinical model

Purpose: Novel 3D digital display systems, such as NGENUITY 3D digitally assisted visualization system (DAVS), can provide enhanced illumination, depth of field, and digital filtering. This study compared vitreous removal using NGENUITY 3D DAVS with a standard surgical microscope. Methods: This was an in vivo, 2-arm laboratory study in 15 Yorkshire pig eyes. The LuxOR LX3 microscope with NGENUITY 3D DAVS (arm 1) and the LuxOR LX3 microscope alone (arm 2) were used with 5× optical magnification and Oculus BIOM 200 mm optics. Standard core and peripheral vitrectomy without scleral depression was performed using the CONSTELLATION Vision System. Residual vitreous weight was assessed in enucleated eyes by a masked observer. Axial length and vitreous weight of contralateral eyes were compared from an additional 14 Yorkshire pigs to confirm that eyes from a single animal were essentially identical. Results: After vitrectomy, mean ± SD residual vitreous was significantly smaller with NGENUITY versus standard microscope (0.143 ± 0.146 versus 0.580 ± 0.269 g, respectively; P < 0.0001). Based on a mean initial vitreous weight of 2.5 g, as determined by assessment in contralateral eyes from an additional 14 Yorkshire pigs, the mean percentage vitreous removal was 94% ± 6% versus 77% ± 11%, respectively. Further, vitreous weight and axial length for contralateral eyes from any single animal in these additional 14 animals were essentially identical, as mean differences were 0.046 ± 0.035 g and 0.11 ± 0.08 mm, respectively. Conclusion: Vitrectomy with NGENUITY 3D DAVS resulted in significantly less residual vitreous in pig eyes compared with standard microscopy. NGENUITY may improve vitreous removal during vitreoretinal surgery by enhancing visualization.