Comparison of surgeon muscular properties between standard operating microscope and digitally assisted vitreoretinal surgery systems

Purpose:To quantitatively analyze surgical ergonomics between standard operating microscope (SOM) and digitally assisted vitreoretinal surgery (DAVS) systems.Methods:The surgeon conducted procedures on 110 patients; 52 patients underwent a combined phacoemulsification and pars plana vitrectomy (Phaco-PPV group, 24 using SOM and 28 using DAVS), and 58 patients underwent phacoemulsification (Phaco group, 30 using SOM and 28 using DAVS). The surgeon's muscle tone and stiffness in the sternocleidomastoid and the two positions of the upper trapezius (UT), which are 2-cm intervals along the UT muscle fibers, UT1 and UT2, were measured at preoperative, intraoperative, and postoperative time points.Results:In the Phaco-PPV group using the SOM, intraoperative muscle tone and stiffness were higher than preoperative and postoperative values in the sternocleidomastoid (P < 0.001, respectively), UT1 (P < 0.001, respectively), and UT2 (P < 0.001 and P < 0.01, respectively). In the Phaco group using the SOM, intraoperative muscle tone and stiffness were higher than pre- and postoperative values in the sternocleidomastoid (P < 0.001, respectively) and UT1 (P < 0.001 and P < 0.01, respectively). By contrast, when the surgeon used the DAVS, there were no differences in muscle properties at any measurement site or during any time point in the Phaco-PPV and Phaco groups (P > 0.05).Conclusion:This study provides quantitative measurement of retina surgeon ergonomics, suggesting that compared with a SOM, the DAVS can reduce intraoperative muscle fatigue.