Real-life comparison of the viewing angle and the image quality of two commonly used viewing systems for vitreoretinal surgery

Background/aim: To compare the clinical use, image quality and viewing angle of a commonly used contact wide angle viewing (WAV)system (Advanced Visual Instruments (AVI) Panoramic Imaging Systems, NY, USA) with a commonly used noncontact WAV system(Leica RUV800, Leica Microsystems, Switzerland).Materials and methods: Images of 42 consecutively operated eyes were obtained with both systems at the same surgical stages and werecompared for image quality using the Imatest Master 4.5.13 (Imatest LLC, Boulder, USA) software. The viewing angles of the imageswere calculated using the optic disc sizes measured from the OCT and infrared fundus images. The 68-degree AVI lens was comparedwith the 90-dioptre (D) Leica RUV800 lens, while the 130-degree AVI lens was compared with the 132-D Leica RUV800 lens. Thesurgical assistants were asked to grade the difficulty of holding the lens in place from 1 to 10, 1 being the easiest and 10 being the mostdifficult.Results: The contact system provided wider viewing angles with higher quality compared to the noncontact system both under fluid andair media. The difference was clinically significant in eyes with impaired corneal clarity, very high myopia, or small pupil. The difficultyof holding the lens in place ranged from 4 to 7, and decreased gradually with practice.Conclusions: Both WAV systems provided high image quality and adequate viewing angles in most cases. However, the contact systemappeared to provide a superior image quality and/or a wider viewing angle in more challenging situations. The difficulty of holding thecontact lens in place was found to be moderate.

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