June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Clinical experience with the first commercially available intraoperative optical coherence tomography system (iOCT)
Author Affiliations & Notes
  • Matthias D Becker
    Ophthalmology, Triemli Hospital, Zürich, Switzerland
    Ophthalmology, University of Heidelberg, Heidelberg, Germany
  • Maximilian Pfau
    Ophthalmology, Triemli Hospital, Zürich, Switzerland
  • Stephan Michels
    Ophthalmology, Triemli Hospital, Zürich, Switzerland
  • Footnotes
    Commercial Relationships Matthias Becker, Alcon (F), Allergan (F), Bayer (F), Novartis (F), Santen (F); Maximilian Pfau, None; Stephan Michels, Alimera (C), Allergan (C), Bayer (C), Clanotech (C), Esbatech (C), Novartis (C), Roche (C), Sucampo (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5909. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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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