Comparison of Simulated Surgical Skills Using Different Camera Aperture Settings for Digitally Assisted Vitreoretinal Surgery

Abstract

Purpose:

This cross-sectional, randomized, single-blinded study evaluates simulated surgical skills during digitally assisted vitreoretinal surgery (DAVS) with different camera aperture settings to determine maximal surgical performance and preference.

Methods:

Fifteen retina fellows performed 3 different surgical simulator tests with a DAVS visualization system. To evaluate maximal surgical performance and preference, DAVS was evaluated at different camera apertures (30% and 75%) with a fixed magnification (12×) and television (TV) viewing distance (1.2 m [4 ft]). Comparisons were made of the time needed to complete each test as well as the number of errors. At the end of the 3 tests, participants were asked for their camera aperture preference.

Results:

The time it took to perform each simulated surgical test was significantly less with the 30% aperture than with the 75% aperture (P = .036). Furthermore, the number of errors made with the 30% aperture was always less than with the 75% aperture (P = .009). After completing all tests, evaluation of surgeon preference for camera aperture settings showed that 83% of the participants preferred the 30% aperture over the 75% aperture.

Conclusions:

Optimization of DAVS parameters directly influences surgical performance. A 30% camera aperture in DAVS outperforms larger camera apertures, not only in depth of field and lateral resolution values, but also in simulated surgical skills. A smaller number of errors, as well as less time needed to complete tests, was achieved with these settings. We suggest that the optimal settings for DAVS enhancement are a 30% camera aperture and a TV viewing distance of 1.2 m.