DOI: 10.4103/ijo.ijo_1332_23 ISSN: 0301-4738

3D visualization system and standard operating microscope for ease of visualization and surgeon comfort during phacoemulsification surgery

Naren Shetty, Aishwarya, Rohitha P Nayak, Luci Kaweri, Ravi Krishna Kanaradi, Anchana A Pisharody
  • Ophthalmology


To compare the ease of visualization and comfort of the surgeon during phacoemulsification surgery using NGENUITY® 3D (NG) visualization system and standard operating microscope (SOM).


In this prospective, randomized, single-blind, single-center study, patients undergoing phacoemulsification surgery by one of the five surgeons were randomly assigned to two groups based on the visualization modality—NG and SOM. Ease of visualization and comfort of the surgeon was assessed using a 27-parameter in-house Surgeon Comfort Score questionnaire.


A total of 224 phacoemulsification with intraocular lens implantations were performed in senile immature cataract (SIMC, n = 174) and mature cataract patients (MC, n = 50). Surgeon’s ease of visualization (4.92–5.00) and hand–eye coordination score (4.97–5.00) were comparable between the NG- and SOM-groups. Postoperative neck discomfort was lower in both the groups, with a relatively lower discomfort in the NG-group (score: 1.04 vs 1.56). The Spearman rank correlation coefficient (r) between illumination of the operation theatre room and the surgical field revealed a weak negative correlation for most of the patients in the NG-group, and a positive correlation for patients in the SOM-group. No correlation was obtained between brightness of the surgical field and comfort with the surgical field brightness.


Similar ease of visualization was experienced by the surgeons using NG- and SOM-system. Neck discomfort postsurgery was numerically lower in the NG-group, although not significant. Additionally, the NG-system permitted the safe performance of phacoemulsification using a lower surgical field illumination.

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