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ankur singh, Bruttendu mohrana, ajay jurangal, aman kumar, SIMAR RAJAN SINGH, Mohit Dogra, Mangat Ram Dogra, Ramandeep Singh; Efficacy of Intraoperative OCT in Various Vitreoretinal Indications. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1876.
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© ARVO (1962-2015); The Authors (2016-present)
Intraoperative Optical coherence tomography (iOCT) has recently been introduced into the vitreoretinal surgery. We evaluated the efficacy of (iOCT) in surgical decision making for various vitreoretinal indications.
In a retrospective study, surgical data of patients undergoing iOCT assisted procedures from July 2018 to Nov 2018 was collected. Participants included patients undergoing any posterior segment procedures who underwent iOCT imaging with microscope-integrated iOCT systems (i.e., Zeiss Rescan 700). These patients were divided into four groups. In Group A, intraoperative OCT was used as an alternative to surgical steps that required surgical adjutants like various dyes; triamcinolone; proportional reflux hydro-dissection; in Group B, iOCT acted as a guide to surgical step as in cases of subretinal TPA injection, macular hole surgeries with autologous neurosensory retinal autograft; in Group C, intraoperative new findings were viewed by iOCT, and it led to additional surgical maneuver; in Group D, iOCT acted as diagnostic tool in paediatric patients undergoing examination under anesthesia (EUA). We evaluated the efficacy and usefulness of the iOCT in managing these indications
Forty-one eyes of 41 patients were enrolled in the study. iOCT demonstrated successful image acquisition and provided useful information in 38 eyes (92.68%, 95% confidence interval [CI], 91.8%-93.24% ). Group A, B, C, D included 21,4,11, and 5 eyes respectively. In Group A, in 17(85.95% 95% CI, 85.01%-86.24%) of 21eyes, iOCT was able to visualize the tissue of interest and we were able to complete the surgical steps without the need for surgical adjuvants. In Group B, in all 4 eyes iOCT acted as a useful guide to a surgeon and helped him to carry out the surgical procedure without trauma to adjacent retinal tissue. In Group C, iOCT was done in 11 eyes to confirm the clinical diagnosis. In 3 (27.27%) of 11 patients, additional findings were seen in iOCT, that lead to additional surgical maneuver. These were diabetes patients where vitreoschisis like picture was identified on iOCT. In Group D, successful image acquisition was done in 4 (80%) of the 5 eyes at the time of EUA. All 4 eyes had normal foveal anatomy.
In our experience, iOCT has come up as an important and promising tool in surgical decision making to achieve better results. It has the potential to reduce the use of various surgical adjuvants.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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