June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017

Analysis of Architectural Retinal Changes Utilizing Intraoperative OCT Following Surgical Interventions with the Membrane Flex Loop in the DISCOVER Study
Author Affiliations & Notes
  • Justis Ehlers
    Cole Eye Institute-Retina Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Oklahoma, United States
  • Atsuro Uchida
    Cole Eye Institute-Retina Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Oklahoma, United States
  • Jamie Reese
    Cole Eye Institute-Retina Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Oklahoma, United States
  • Carmen Calabrise
    Cole Eye Institute-Retina Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Oklahoma, United States
  • Sunil K Srivastava
    Cole Eye Institute-Retina Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Oklahoma, United States
  • Footnotes
    Commercial Relationships   Justis Ehlers, Alcon (C), Alcon (F), Bioptigen (C), Bioptigen (P), Leica (C), Leica (P), Regeneron (F), Synergetics (P), Thrombogenics (C), Thrombogenics (F), Zeiss (C); Atsuro Uchida, None; Jamie Reese, None; Carmen Calabrise, None; Sunil Srivastava, Alcon (C), Allergan (F), Bausch and Lomb (C), Bioptigen (P), Leica (P), Santen (C), Synergetics (P), Zeiss (C)
  • Footnotes
    Support  NIH/NEI K23-EY022947; Ohio Department of Development TECH-13-059
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1188. doi:
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      Justis Ehlers, Atsuro Uchida, Jamie Reese, Carmen Calabrise, Sunil K Srivastava;
      Analysis of Architectural Retinal Changes Utilizing Intraoperative OCT Following Surgical Interventions with the Membrane Flex Loop in the DISCOVER Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1188.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate acute retinal alterations identified on intraoperative optical coherence tomography (iOCT) immediately following surgical intervention with the membrane flex loop for vitreoretinal interface disorders.

Methods : The DISCOVER study is an IRB-approved prospective microscope-integrated iOCT study for ophthalmic surgery. This study included subjects who had participated in the DISCOVER study and had undergone macular surgery with the membrane flex loop (FINESSE Flex Loop, Alcon, Ft Worth, TX) utilization from August 2014 to July 2016 were identified., iOCT images and video sequences were evaluated various surgical time points. Subjects were excluded if iOCT images were not obtained over the area of membrane peeling performed with the membrane flex loop. Qualitative characteristics of intraoperative changes in retinal images were analyzed, with particular focus on the retinal layers within the bed of membrane peeling performed specifically with the membrane flex loop.

Results : There were 34 eyes of 34 patients with a mean age of 72.7 years, 25 of whom were woman. The intraoperative diagnosis was full thickness macular hole in 21 eyes (62%) and epiretinal membrane in 13 eyes (38%). All eyes had successful indocyanine green assisted ILM flap initiation utilizing the membrane loop. iOCT demonstrated expansion of the ellipsoid zone to retinal pigment epithelium distance in 3 eyes (9%), definitive subretinal fluid accumulation in 1 eye (3%), and hyperreflectivity of the inner retinal layers associated with retinal hemorrhage in 10 eyes (29%). Retinal breaks were not observed in any of the eyes.

Conclusions : Acute retinal alterations after ILM peeling with the membrane flex loop were visualized at a frequency of less than 10%. Additional research is needed to understand the clinical impact, if any, of these architectural alterations.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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