Optimization of Surgeon Ergonomics With Three-dimensional Heads Up Display for Ophthalmic Surgeries

Abstract Purpose: To describe the variables that may be utilized in the optimization of three dimensional heads up surgeries (3D-HUS) for achieving better ergonomics among ophthalmic surgeons. Methods: A cross-sectional study conducted at the operating room of a tertiary eye care centre, equipped with ARTEVO 800 3D surgical microscope and display monitor. The parameters noted were: monitor height (MH), surgeon eye to floor distance (ETFD) surgeon eye to monitor distance (ETMD) (Fig. 1a) and viewing tilt (VT) angle. The neck and eye strain of the surgeon and assistant were scored as per Borg’s CR-10 scale, before and after surgeries.Results: 15 surgeries were analysed. The minimum ETMD was 51 inches and eye strain reduced with shorted ETMD. VT and ETFD was higher for right eye surgeries. The optimum MH was between 50 to 55 inches. Overall, neck strain and eye strain were in the range of 0-3 and 0-1, respectively.Conclusion: The various parameters affecting 3D image quality, neck and eye strain are: chair height, viewing tilt angle, eye centration, monitor distance, laterality of the eye and room illumination.