Reduced field of view under the surgical microscope due to personal protective equipment: lessons learned during the COVID-19 pandemic

Celtikci E., Karaaslan B., Börcek A. Ö., Emmez Ö. H.

Neurosurgical Focus, vol.49, no.6, pp.1-3, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 49 Issue: 6
  • Publication Date: 2020
  • Doi Number: 10.3171/2020.9.focus20370
  • Journal Name: Neurosurgical Focus
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.1-3
  • Keywords: COVID-19, neurosurgery, personal protective equipment, SARS-CoV-2
  • Gazi University Affiliated: Yes


© AANS 2020.OBJECTIVE During the coronavirus disease 2019 (COVID-19) pandemic, neurosurgeons all around the globe continue to operate in emergency cases using new self-protective measures. Personal protective equipment (PPE) use is recommended in all surgeries. The authors have experienced varying degrees of field of view (FOV) loss under the surgical microscope with different PPE. Herein, they aimed to investigate the effects of different PPE on FOV while using the surgical microscope. METHODS Fifteen neurosurgeons and neurosurgery residents participated in this study. Three kinds of PPE (safety spectacles, blast goggles, and face shields) were tested while using a surgical microscope. FOV was measured using a 12 × 12–cm checkered sheet of paper on which every square had an area of 25 mm2 under the microscope. The surgical microscope was positioned perpendicular to the test paper, and the zoom was fixed. Each participant marked on the test sheet the peripheral borders of their FOV while using different PPE and without wearing any PPE. A one-way repeatedmeasures ANOVA was performed to determine if there was a significant difference in FOV values with the different PPE. RESULTS FOV was significantly different between each PPE (F[3, 42] = 6339.845, p < 0.0005). Post hoc analysis revealed a significant decrease in the FOV from the naked eye (9305.33 ± 406.1 mm2) to blast goggles (2501.91 ± 176.5 mm2) and face shields (92.33 ± 6.4 mm2). There were no significant FOV changes with the safety spectacles (9267.45 ± 410.5 mm2). CONCLUSIONS While operating under a surgical microscope safety spectacles provide favorable FOVs. Face shields increase the eye piece–pupil distance, which causes a severe reduction in FOV.