Intraoperative SD-OCT in macular surgery.

Francesco Pichi, Micol Alkabes, Paolo Nucci, Antonio P. Ciardella

Research output: Contribution to journalArticle

Abstract

Intraoperative use of spectral-domain optical coherence tomography (SD-OCT) using an OCT-mounted surgical microscope could provide additional information to predict visual outcomes of macular surgery and identify intraoperative changes in the macular anatomy that affect visual recovery. This interventional retrospective case study included 5 eyes of 5 consecutive patients with various macular pathologies. All patients underwent the standard surgery for idiopathic macular holes and epiretinal membranes (ERMs) using the same 25-gauge three-port pars plana technique. If present, the ERM was removed. The dye procedure was then repeated to stain and remove the internal limiting membrane (ILM). OCT images were obtained with the retinal map or cross-section program preincision, post-hyaloid elevation (if applicable), post-residual ERM peel (if applicable), and post-ILM peel. In 3 of 5 patients, the intraoperative scan revealed an increased area of subretinal hyporeflectivity corresponding with a clinically visible "cuff" of retinal detachment. In 2 patients, the SD-OCT scan taken immediately after ERM removal helped find a cleavage plane for the subsequent ILM peeling, which could be further confirmed by a scan taken immediately after it. In 2 cases, the scans identified intraoperative complications that otherwise would not have been noted and allowed the surgeon to modify the next procedures during surgery. Use of this technology in an operative setting can provide greater insight into the changes in retinal anatomy created during macular surgery.

Original languageEnglish
JournalOphthalmic Surgery Lasers and Imaging
Volume43
Issue number6 Suppl
Publication statusPublished - Nov 2012

ASJC Scopus subject areas

  • Medicine(all)

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    Pichi, F., Alkabes, M., Nucci, P., & Ciardella, A. P. (2012). Intraoperative SD-OCT in macular surgery. Ophthalmic Surgery Lasers and Imaging, 43(6 Suppl).