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Matthias D Becker, Maximilian Pfau, Stephan Michels; Clinical experience with the first commercially available intraoperative optical coherence tomography system (iOCT) . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5909.
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A retrospective, single-center, case-series was initiated to evaluate the first clinical experience with the first commercially available intraoperative optical coherence tomography system (iOCT) for the enhancement of ophthalmic surgery.
The Rescan 700 system (Zeiss, Oberkochen, Germany), a spectral-domain OCT system integrated into a Lumera 700 surgical-microscope (Zeiss, Oberkochen, Germany), was used in 40 consecutive cases. A standardized review was used to assess whether the iOCT-imaging resulted in additional information or/and altered decision-making. Additionally, the preoperative diagnosis, surgical procedures and total iOCT-imaging time were documented to analyze potentially increased surgery time.
For anterior and posterior segment surgical procedures, iOCT-imaging was found to be beneficial.<br /> The surgeons in this study reported that iOCT-imaging provided additional information in 74.1% of the posterior and combined surgical cases (n=31), which resulted in 41.9% of the cases in altered decision-making. The iOCT imaging time amounted on average to 167 seconds (SD =77 seconds). In addition, it showed to be usable in conjunction with common chromovitrectomy-dyes and different tamponades. Furthermore, iOCT-imaging allowed evaluation of iatrogenic effects during surgery and subsequent minimization.<br /> In anterior procedures (n=9), the surgeons reported gain of additional information in 22.2% of all cases and no case of altered decision-making. In these procedures, the iOCT imaging time amounted on average to 117 seconds. Among others, the following aspects were evaluated: corneal incisions with regard to size, positioning and extension; anterior capsular rhexis; hydrodisection with imaging of the posterior capsule; phacoemulsification and incision closure by hydration.<br /> Novel intraoperative-alterations of the macula, peripheral retina and sclera, which can only be seen on iOCT, were discovered, described and evaluated.
The Rescan 700 system fits into the surgical process and allows intraoperative life-scanning to evaluate different ocular structures for surgical decision making. The here shown results suggest that iOCT has the potential to improve the quality of posterior and anterior segment surgery.
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