Objective:

To compare the effectiveness of autofluorescence devices with the naked eye method in identifying parathyroid glands during thyroid surgery.

Approach:

• Study Design: A propensity score matched study involving patients undergoing total thyroidectomy with or without bilateral central neck dissection.
• Intervention Groups: Patients were divided into groups using the IMAGE1 S™ Rubina® camera, Fluobeam® LX, and a control group using the naked eye.
• Data Collection: Data was collected from a prospectively maintained database from 01/01/2024 to 31/08/2025.

Key Findings:

• 292 patients were included, with 37 patients per group after propensity score matching.
• Higher odds of identifying parathyroid glands were found with Rubina® (OR 2.56, 95% CI 1.10–5.97) and Fluobeam® (OR 4.12, 95% CI 1.71–9.95) compared to the naked eye.
• No significant difference in identification rates between Rubina® and Fluobeam® (OR 1.67, 95% CI 0.72–3.88).
• Postoperative PTH levels were significantly higher in the autofluorescence groups compared to the naked eye group.

Interpretation:

Detection rates of parathyroid glands improved with autofluorescence devices compared to the naked eye.

Limitations:

• Exclusion of patients with concurrent hyperparathyroidism or renal insufficiency may limit generalizability.
• The study only included patients undergoing total thyroidectomy, which may not represent all thyroid surgery cases.

Conclusion:

Both autofluorescence devices improved parathyroid gland identification rates compared to the naked eye.