Purpose: To evaluate a 3-D visualization helmet (3DVH) during 23-gauge pars plana vitrectomy (PPV) for macular holes (MH) and macular puckers (MP). Methods: A total of 184 eyes of 184 patients undergoing PPV for MH or MP were randomly selected for surgery with 3DVH or standard Galilean microscope (GM). Only one highly trained surgeon performed each PPV. A surgical comfort score, ranging from 1 to 10 was recorded after each operation. Statistical analysis was run with SPSS to compare parameters before and after surgery and between the two groups. Results: No statistical differences were found between the two groups for mean best correct visual acuity improvement after surgery (p < 0.001). Mean surgery comfort evaluation was 7.63 ± 0.48 in 3DVH eyes and 8.21 ± 0.62 in GM ones (p = 0.09); mean overall surgical time was 35.12 ± 3.8 min in 3DVH eyes and 32.7 ± 2.27 min in GM ones (p < 0.001); mean peeling time was 14.24 ± 3.42 min in 3DVH eyes and 13.61 ± 4.63 min in GM ones (p = 0.11). Conclusions: According to the data observed in this study, the 3DVH provides adequate safety and efficacy in retinal and macular visualization during PPV for MH and MP.
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