Intraoperative optical coherence tomography using an optimized reflective optical relay, real-time heads-up display, and semitransparent surgical instrumentation

2015 ◽  
Author(s):  
Yuankai K. Tao ◽  
Mohamed T. El-Haddad ◽  
Sunil K. Srivastava ◽  
Daniel Feiler ◽  
Amanda I. Noonan ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Optical Coherence ◽  
Surgical Instrumentation ◽  
Intraoperative Optical Coherence Tomography

scholarly journals Intraoperative Optical Coherence Tomography Using the RESCAN 700: Preliminary Results in Collagen Crosslinking

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Natasha Pahuja ◽  
Rohit Shetty ◽  
Chaitra Jayadev ◽  
Rudy Nuijts ◽  
Bharath Hedge ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Imaging Study ◽  
Software Tool ◽  
Optical Coherence ◽  
Average Depth ◽  
Collagen Crosslinking ◽  
Intraoperative Optical Coherence Tomography ◽  
The Mean

Purpose. To compare the penetration of riboflavin using a microscope-integrated real time spectral domain optical coherence tomography (ZEISS OPMI LUMERA 700 and ZEISS RESCAN 700) in keratoconus patients undergoing accelerated collagen crosslinking (ACXL) between epithelium on (epi-on) and epithelium off (epi-off).Methods. Intraoperative images were obtained during each of the procedures. Seven keratoconus patients underwent epi-on ACXL and four underwent epi-off ACXL. A software tool was developed using Microsoft.NET and Open Computer Vision (OpenCV) libraries for image analysis. Pre- and postprocedure images were analyzed for changes in the corneal hyperreflectance pattern as a measure of the depth of riboflavin penetration.Results. The mean corneal hyperreflectance in the epi-on group was 12.97 ± 1.49 gray scale units (GSU) before instillation of riboflavin and 14.46 ± 2.09 GSU after AXCL (P= 0.019) while in the epi-off group it was 11.43 ± 2.68 GSU and 16.98 ± 8.49 GSU, respectively (P= 0.002). The average depth of the band of hyperreflectance in the epi-on group was 149.39 ± 15.63 microns and in the epi-off group it was 191.04 ± 32.18 microns.Conclusion. This novelin vivo, real time imaging study demonstrates riboflavin penetration during epi-on and epi-off ACXL.

Real-Time Assessment of Intraoperative Vaulting in Implantable Collamer Lens and Correlation with Postoperative Vaulting

2016 ◽  
Vol 27 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Jeewan S. Titiyal ◽  
Manpreet Kaur ◽  
Suman Sahu ◽  
Namrata Sharma ◽  
Rajesh Sinha
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Implantable Collamer Lens ◽  
Paired Samples ◽  
Snellen Visual Acuity ◽  
Intraoperative Optical Coherence Tomography ◽  
The Mean

Purpose To assess the intraoperative vaulting in patients undergoing implantable collamer lens (ICL) implantation with microscope-integrated intraoperative optical coherence tomography (iOCT) and correlate it with the postoperative vaulting. Methods Forty eyes of 22 consecutive patients undergoing ICL implantation were prospectively evaluated. Vaulting was measured intraoperatively using microscope-integrated iOCT. The ICL-lenticular relationship was dynamically assessed throughout the surgery. Postoperative vaulting was measured using anterior segment optical coherence tomography on the first postoperative day and after 1 month and compared with the intraoperative vaulting. Uncorrected and best-corrected Snellen visual acuity, intraocular pressure (IOP), and anterior and posterior segments were assessed in all cases. Results The mean central vaulting noted intraoperatively was 558.4 ± 122.8 µm. Postoperative mean vaulting was 576.0 ± 131.2 µm on day 1 and 551.1 ± 122.5 µm on day 30. There was a significant correlation between the intraoperative and the postoperative day 1 vaulting (paired samples correlation: 0.969, p<0.001) and day 30 vaulting (paired samples correlation: 0.945, p<0.001). An ICL-lenticular touch was not noted at any time during the surgery. The postoperative course was uneventful and no patient developed raised IOP or lenticular changes by the last follow-up. Conclusions Intraoperative vaulting correlates well with postoperative vaulting and can aid in on-table detection of extremes of vaulting and decision-making. It enhances the safety of the surgical procedure by providing a real-time display of the intraoperative manipulations.

scholarly journals Intraoperative Optical Coherence Tomography-Assisted 27-Gauge Vitrectomy in Eyes with Vitreoretinal Diseases

2015 ◽  
Vol 6 (2) ◽  
pp. 216-222 ◽  
Author(s):  
Hiroshi Kunikata ◽  
Toru Nakazawa
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Case Series ◽  
Retinal Disease ◽  
Optical Coherence ◽  
Vitreoretinal Disease ◽  
Intraoperative Optical Coherence Tomography ◽  
Vitreoretinal Diseases ◽  
Microincision Vitrectomy Surgery ◽  
Intraoperative Visualization

Objective: To report intraoperative optical coherence tomography (iOCT)-assisted 27-gauge microincision vitrectomy surgery (MIVS) in eyes with vitreoretinal disease. Methods: A retrospective, interventional case series performed at a single center, including 6 eyes with retinal disease that underwent iOCT-assisted 27-gauge MIVS. Results: The advantages of iOCT were most notable when it was used to evaluate, in real time, different macular areas: the pre-macula, in vitreomacular traction or epiretinal membrane; the intra-macula, in macular edema or macular hole; and the sub-macula, in macular detachment. Real-time imaging and the minimization of shadows cast on the underlying tissues by the 27-gauge instrumentation made it possible to quickly select the best procedure at each critical juncture of the surgery. No patients experienced any complications. Conclusion: Real-time iOCT imaging during 27-gauge MIVS provided excellent intraoperative visualization of retinal tissues without causing significant obstructions to the surgeon. The positive feedback from the system allowed the surgeon to better judge the necessity of additional surgical procedures.

scholarly journals Intraoperative Optical Coherence Tomography-Guided Bleb-sparing Epithelial Exchange: A Modified Approach

2021 ◽  
Author(s):  
Dewang Angmo ◽  
Jyoti Shakrawal ◽  
Ramanjit Sihota
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Real Time ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Direct Visualization ◽  
Operating Microscope ◽  
Surgical Time ◽  
Intraoperative Optical Coherence Tomography ◽  
Intraoperative Oct

With the advent of newer technologies, real-time anterior segment optical coherence tomography (OCT) integrated with the operating microscope has become possible. We are proposing the technique of bleb revision with greater precision under direct visualization of bleb anatomy and extent of tissue depth allowing better localization and easy maneuvering with lesser complications. In this surgical technique, bleb revision was performed using intraoperative real-time OCT incorporated in OPMI LUMERA 700 microscope. Live surgical and OCT view were seen on a common screen together. A moderately elevated, diffuse functional bleb was noted after three months of bleb revision in both cases with controlled intraocular pressure. Intraoperative OCT-guided bleb-sparing epithelial exchange is an adjunctive technique for bleb repair surgery with an increased precision of surgery which can reduce complications, minimize surgical time and maximize surgical outcome.

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