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Guidesvsaugmentedreality131705–1meterTheQRpatternwaslaser-engravedonmedicalgradestainlesssteeltomakethemarkerssterilisableandreusableforfuturesurgicalimplementation26EvenundervaryingsurgicallightningthemarkerswererecognisedbytheHoloLensTopreventanyvisualisationerrorstheobserverswereinstructedtometiculouslyadjustthepositionoftheHoloLensontheirheadwhilelookingatthepointerOnlywhentheholographicpointerhadanexactoverlapwiththerealpointer,theHoloLenswasconsideredcorrectlypositioned Thisessentialbuttime-consumingandcumbersomestepwasrepeatedeverytimetheHoloLenswasputonFutureupdatesofARglasseswitheyecalibrationwouldmakethisstepobsoleteThebinoculardisplayoftheHoloLensisoneofitskeyfeaturesandprovidesexcellent depth perception that facilitates the inspection of complex 3D anatomicalstructures27Becauseprojectinglargeholograms within the surgeon’s working view(±50cm)canresultindiscomfortthevirtualplanningpointswerekeptsmallandvisualised justabovetherealmodelsFurthermorethecolouredindicationarrowandthedistancetotargetindication(Figure3)wereplaced justoutsidethefocusviewof thesurgeoninourHoloLensapplication Thisallowed theuser tomaintainthenaturallinkbetweenthevirtualelementsandrealworldandledtoincreasedcomfortsharper visualizationandreduceddoubleimages ThisturnedouttobeavaluableadditiontotheexperimentsashadalreadybeensuggestedbyGaoetalwhousedthisinasimilarHoloLensapplicationformandibularsurgery25ForcraniosynostosissurgeryHanetalimplementedARtotransferaVSPanddescribedexcellentpost-opresults24Insteadofahead-mounteddisplaytheyusedavideocaptureofthesurgicalsiteandaugmentedthiswiththevirtualplanSince(transparent)stereoscopicglassesenableatrue3DperceptionandmakesadditionalscreenssuperfluouswebelievestronglyinthepotentialofAR-glassesoverdisplaysUsuallya VSPconsistsof twophasesmarking theosteotomylinesandperformingthecranialreconstructionThisstudyfocusedonthefirstphasewhichallowaneasyandstraightforwardcomparisonbetweentransfermethodsYetweexpecttheaddedvalueofARduringthereconstructionphasewillbemoreevidentbecausethisphaseissurgicallymorechallengingandARcouldassistthesurgeon
