Artificial Intelligence in Vitreoretinal Surgery: A Systematic Review of Current Applications and Future Directions
Abstract
Introduction: To examine the current landscape of artificial intelligence (AI) applications in vitreoretinal (VR) diseases and surgery, with the aim of identifying knowledge gaps and guiding future directions in this rapidly evolving field.
Methods: Systematic review including original studies involving the use of AI and focusing on VR pathologies. A comprehensive electronic search of the literature was carried out in multiple databases.
Results: Thirty-seven studies were included. Most evaluated machine learning or deep learning models for preoperative prognostication using optical coherence tomography with or without clinical variables. Predictive performance for postoperative best-corrected visual acuity (BCVA) was high in several cohorts (R2 up to 0.80; area under the receiver operating characteristic curve [AUROC] > 0.95), with models consistently highlighting outer retinal biomarkers as key determinants of visual recovery after epiretinal membrane and macular hole surgery. For anatomical outcomes, deep learning models frequently achieved > 90% accuracy in predicting macular hole closure and retinal reattachment/reattachment-related endpoints. Intraoperative computer-vision systems demonstrated feasibility for real-time instrument detection and tracking, reporting precision above 90% in experimental or early clinical settings. Large language models showed moderate-to-high agreement with expert surgical planning (80-93%) and potential utility in education and workflow…
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Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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