Impact of accommodation, convergence and stereoacuity on perceived symptoms and surgical performance among surgeons
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Impact of accommodation, convergence and stereoacuity on perceived symptoms and surgical performance among surgeons Ameer Alhusuny1 · Margaret Cook2 · Akram Khalil3,4 · Julia Treleaven1 · Andrew Hill5,6,7 · Venerina Johnston8 Received: 9 August 2020 / Accepted: 15 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Minimally invasive surgery (MIS) is not without impact on surgeons’ neck/shoulder/head and eyes. However, the mechanisms for concurrent symptoms are not clear. This study aims to examine the effect of visual impairments on physical symptoms and surgical performance among surgeons performing simulated surgical tasks using two-dimensional (2D) and three-dimensional (3D) viewing modes. Methods Gynaecologists with experience in laparoscopy performed four simulated surgical tasks in the 2D and 3D viewing modes. Visual parameters (accommodation, convergence and stereoacuity) were measured prior to commencement. Objective performance measures were derived from the laparoscopic tasks, and surgeons also self-reported their mental and physical workload using the NASA-TLX. In addition, perceived symptoms were measured using Visual Analogue Scales, the Simulator Sickness Questionnaire and the Computer Vision Syndrome Questionnaire. Results Seventeen healthy gynaecologists participated in this study. There were significant relationships between visual impairments and both the perceived symptoms and surgical performance scores of MIS surgeons. Surgeons with a higher number of accommodation/convergence dysfunctions and/or poorer stereoacuity tended to have poorer objective performance scores on simulated surgical tasks in both viewing modes. NASA-TLX scores indicated that surgeons with poorer stereoacuity also perceived themselves to have been less successful at accomplishing tasks. However, these surgeons also reported less intense physical symptoms and simulator sickness. Conclusions Surgeons’ performance for the simulated surgical tasks correlated with visual functions, and it also impacted on the symptoms experienced. Regular screening of surgeons’ vision and vision therapy may be required to decrease physical symptoms and improve surgical performance. Keywords Accommodation · Convergence · Stereoacuity · Surgeon · MIS · Performance With the proliferation of minimally invasive surgeries (MIS), two-dimensional (2D) and three-dimensional (3D) applications are becoming pervasive in the strive for improved patient outcomes [1]. However, better patient outcomes appear to come at the cost of an increased prevalence of
visual and musculoskeletal symptoms [2] and headaches [3] for those performing MIS. The influence of MIS on the visual system and other parts of the anatomy and the related mechanisms, are not thoroughly understood [4–6].
* Ameer Alhusuny [email protected]
4
Royal Brisbane and Women’s Hospital, Brisbane, Australia
5
Clinical Skills Development Service, Metro North Hospital and Health Service, Brisb
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