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Volume 12
Issue 1
10.3390/safety12010024
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Ergonomic Benefits of Prismatic Deflection Loupes in Ophthalmic Surgery: A Biomechanical and Psychometric Evaluation

by
Jenny N. Wang
1,*,
Brian Ngo
2,
Michael Madsen
3,
Josephine Lu
3,
Christine E. King
2,
Benjamin K. Young
4,
Kourosh Shahraki
1,* and
Donny W. Suh
1
1
Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92697, USA
2
Department of Biomedical Engineering, University of California, Irvine, CA 92697, USA
3
School of Medicine, University of California, Irvine, CA 92697, USA
4
Department of Ophthalmology, Oregon Health & Science University, Portland, OR 97239, USA
*
Authors to whom correspondence should be addressed.
Safety 2026, 12(1), 24; https://doi.org/10.3390/safety12010024 (registering DOI)
Submission received: 28 October 2025 / Revised: 22 January 2026 / Accepted: 4 February 2026 / Published: 6 February 2026
(This article belongs to the Special Issue Advances in Ergonomics and Safety)
Versions Notes

Abstract

Prismatic deflection loupes (PDLs) may offer ergonomic benefits over traditional through-the-lens (TTL) loupes and no loupe during ophthalmic microsurgery. Ten medical students performed microsuturing tasks under three conditions: PDL, TTL, and no loupes. Surface electromyography (EMG) captured bilateral upper trapezius activity, and a post-task 10-point Likert survey assessed comfort and related perceptions. Side-profile photos provided craniovertebral angles, which fed a trigometric model to estimate cervical spine loading (lbf) per condition. Relative to TTL, PDLs reduced upper trapezius activation by 17.2% (p = 0.009); relative to no loupe, PDL reductions were significant (p = 0.004). The TTL and no-loupe conditions did not differ significantly (p = 0.42). Comfort was highest for PDLs (7.8/10 on average); perceived strain was lowest with PDLs. CV angle and estimated cervical load were strongly inversely correlated (R2 = 0.94, p < 0.001). PDLs appear to reduce neck/shoulder muscle activity and cervical loading while enhancing comfort, supporting ergonomic value in ophthalmic surgery.
Keywords: prismatic deflection loupes; electromyography; biomechanics; Likert survey; cervical spine; surgical ergonomics; ophthalmic surgery prismatic deflection loupes; electromyography; biomechanics; Likert survey; cervical spine; surgical ergonomics; ophthalmic surgery

Share and Cite

MDPI and ACS Style

Wang, J.N.; Ngo, B.; Madsen, M.; Lu, J.; King, C.E.; Young, B.K.; Shahraki, K.; Suh, D.W. Ergonomic Benefits of Prismatic Deflection Loupes in Ophthalmic Surgery: A Biomechanical and Psychometric Evaluation. Safety 2026, 12, 24. https://doi.org/10.3390/safety12010024

AMA Style

Wang JN, Ngo B, Madsen M, Lu J, King CE, Young BK, Shahraki K, Suh DW. Ergonomic Benefits of Prismatic Deflection Loupes in Ophthalmic Surgery: A Biomechanical and Psychometric Evaluation. Safety. 2026; 12(1):24. https://doi.org/10.3390/safety12010024

Chicago/Turabian Style

Wang, Jenny N., Brian Ngo, Michael Madsen, Josephine Lu, Christine E. King, Benjamin K. Young, Kourosh Shahraki, and Donny W. Suh. 2026. "Ergonomic Benefits of Prismatic Deflection Loupes in Ophthalmic Surgery: A Biomechanical and Psychometric Evaluation" Safety 12, no. 1: 24. https://doi.org/10.3390/safety12010024

APA Style

Wang, J. N., Ngo, B., Madsen, M., Lu, J., King, C. E., Young, B. K., Shahraki, K., & Suh, D. W. (2026). Ergonomic Benefits of Prismatic Deflection Loupes in Ophthalmic Surgery: A Biomechanical and Psychometric Evaluation. Safety, 12(1), 24. https://doi.org/10.3390/safety12010024

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