Heads‐up eye surgery: pros and cons

Purpose To evaluate the use of Heads‐up approach for eye microsurgical procedures. Methods The Heads‐up system TrueVision 3D Surgical (Santa Barbara, CA, USA) combined with operating microscope Lumera 700 (Carl Zeiss Meditech, Oberkochen, Germany) was used during the surgeries on anterior and posterior segment of the eye by two experienced surgeons. The time that was necessary for getting used to the heads‐up surgery was assessed. The magnification and the colours on the screen were compared with those seen through the ocular of the microscope. The surgeon's posture using standard oculars and heads‐up system was assessed and compared as well. Results The first surgery performed by each surgeon was fully done with he use of heads‐up system. The duration of the first 2 surgeries was approximately 15–20 min longer comparing to the standard approach. The duration of every next surgery was shorter and finally on the 5th surgery didn't differ from the one done with standard approach. The colours on the 3D display were different from those seen through the oculars, but it was possible to do the digital adjustment of the colours. The magnification of the ocular structures with 3D system was bigger comparing to the magnification in standard oculars. The posture of the surgeon was more flexible during the surgeries with 3D system. Conclusions New 3D technology allows the surgeon to work with the bigger magnification and in more relaxed position. The colours of the ocular tissues with 3D system differ from the colours seen through the standard oculars, but can be adjusted by the special software. Heads‐up surgery necessitates a learning curve, which is relatively short.