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3D Head-Up Display versus Standard Operating Microscope for Vitrectomy Surgery: A Systematic Review and Meta-analysis.

PURPOSE
To evaluate the effects of vitrectomy with 3D head-up display (3D HUD) versus standard operating microscope (SOM) for retinal diseases.


METHODS
The PubMed, Cochrane Library, and Embase databases, etc. were comprehensively searched to identify studies that compared 3D HUD versus SOM in vitrectomy for retinal diseases (PROSPERO protocol CRD42021265827). The primary outcomes are duration of surgical time, postoperative best-corrected visual acuity, endoillumination levels, and intraoperative complications. The secondary outcomes are reattachment rate of rhegmatogenous retinal detachment (RRD), macular hole (MH) closure rate, etc.


RESULTS
Fifteen studies of 2,889 eyes were included. Compared with SOM, 3D HUD vitrectomy took a longer surgical time (weighted mean difference [WMD]=1.48, 95% confidence interval [CI], 0.13 to 2.82), but needed lower endoillumination levels (WMD=-16.04, 95% CI, -18.33 to -13.75) than SOM. There were no significant differences in the postoperative best-corrected visual acuity, intraoperative complications, reattachment rate of RRD, or closure rate of MH.


CONCLUSION
Our results suggested that 3D HUD provides lower retinal illumine toxicities but with a longer surgical time. The surgical results and complications of vitrectomy were equally comparable for 3D HUD and SOM.