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Comparative Assessment of Ergonomic Experience with Heads-Up Display and Conventional Surgical Microscope in the Operating Room

Authors Weinstock RJ, Ainslie-Garcia MH, Ferko NC, Qadeer RA, Morris LP, Cheng H, Ehlers JP

Received 14 November 2020

Accepted for publication 23 December 2020

Published 29 January 2021 Volume 2021:15 Pages 347—356


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Robert J Weinstock,1 Margaret H Ainslie-Garcia,2 Nicole C Ferko,2 Rana A Qadeer,2 Leighton P Morris,3 Hang Cheng,3 Justis P Ehlers4,5

1Eye Institute of West Florida, Largo, FL, USA; 2Eversana, Burlington, ON, Canada; 3Alcon Vision LLC, Fort Worth, TX, USA; 4Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cleveland Clinic, Cleveland, OH, USA; 5Vitreoretinal Service, Cole Eye Institute, Cleveland, OH, USA

Correspondence: Justis P Ehlers
Cole Eye Institute, 9500 Euclid Ave/I32, Cleveland, OH, USA
Tel +1 216-636-0183

Purpose: Musculoskeletal pain issues are prevalent in ophthalmic surgeons and can impact surgeon well-being and productivity. Heads-up displays (HUD) can improve upon conventional microscopes by reducing ergonomic stress. This study compared ergonomic outcomes between HUD and a conventional optical microscope in the operating room, as reported by ophthalmic surgeons in the US.
Methods: An online questionnaire was distributed to a sample of surgeons who had experience operating with HUD. The questionnaire captured surgeon-specific variables, the validated Nordic Musculoskeletal Questionnaire, and custom questions to compare HUD and conventional microscope. A multivariable model was built to identify variables that were likely to predict improvement in pain-related issues.
Results: Analysis was conducted on 64 surgeons (37 posterior-segment, 25 anterior-segment, and two mixed) with a mean 14.9 years of practice and 2.3 years using HUD. Most surgeons agreed or strongly agreed that HUD reduced the severity (64%) and frequency (63%) of pain and discomfort, improved posture (73%), and improved overall comfort (77%). Of respondents who experienced headaches, or pain and discomfort during operation, 12 (44%) reported their headaches improved and 45 (82%) reported feeling less pain and discomfort since they started using HUD. The multivariable model indicated the odds of reporting an improvement in pain since introducing the HUD in the operating room were 5.12-times greater for those who used HUD in > 50% of their cases (P=0.029).
Conclusion: This study indicates that heads-up display may be an important tool for wellness in the operating room as it can benefit ophthalmic surgeons across several ergonomic measures.

Keywords: heads-up display, microscope, ergonomic, musculoskeletal disorders, ophthalmology, surgery

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