Pediatric Vitreoretinal Surgery and Integrated Intraoperative Optical Coherence Tomography

2021 ◽  
pp. 15-25
Author(s):  
Sophie Cai ◽  
Anthony Therattil ◽  
Lejla Vajzovic
Keyword(s):  
Optical Coherence Tomography ◽  
Vitreoretinal Surgery ◽  
Optical Coherence ◽  
Intraoperative Optical Coherence Tomography

INTRAOPERATIVE OPTICAL COHERENCE TOMOGRAPHY (OCT) GUIDANCE OF VITREORETINAL SURGERY

2020 ◽  
Vol 71 (3) ◽  
pp. 513-526
Author(s):  
Hesham Gabr ◽  
SherifZaki Mansour ◽  
Sherif Embabi ◽  
Tamer Mahmoud ◽  
Cynthia Toth
Keyword(s):  
Optical Coherence Tomography ◽  
Vitreoretinal Surgery ◽  
Optical Coherence ◽  
Intraoperative Optical Coherence Tomography

scholarly journals Feasibility and utility of intraoperative optical coherence tomography during vitreoretinal surgery: A 4-year report in Chinese population

2020 ◽  
pp. 2140004
Author(s):  
Jiwei Tao ◽  
Huan Chen ◽  
Jiafeng Yu ◽  
Dan Cheng ◽  
Yiqi Chen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Chinese Population ◽  
Operative Procedure ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Vitreous Hemorrhage ◽  
Optical Coherence ◽  
Surgical Methods ◽  
Intraoperative Optical Coherence Tomography

Purpose: To introduce the application of intraoperative optical coherence tomography (iOCT) in pars plana vitrectomy (PPV) for various vitreoretinal diseases, and to report the 4-year assessment of feasibility and utility in Chinese population. Methods: Retrospective case series of patients who underwent PPV and iOCT scan at Eye Hospital of Wenzhou Medical College from January 2016 to January 2020. Clinical characteristics were documented before operation, and we intraoperatively recorded the time and results of iOCT scanning, specific surgical maneuvers performed, the consistency with the planned strategies before surgery, the type of OCT images obtained, and adverse events (AEs). The surgeon feedback was collected to evaluate the utility of iOCT during surgery. Results: 339 eyes successfully completed iOCT scan, with an average scanning time of [Formula: see text][Formula: see text]min, including 59 cases of idiopathic macular hole (iMH), 134 cases of idiopathic epiretinal membrane (iERM), 33 cases of lamellar macular hole (LMH), 40 cases of high myopic maculopathy, 13 cases of vitreous macular traction (VMT), 60 cases of dense vitreous hemorrhage (VH). The iOCT findings were not consistent with examination under the operating microscope in 49 cases (14.5%), including 29 cases (8.6%) which changed the operation strategies during surgery. The Hole-door phenomenon arose in 20 cases (33.9%) of iMH and 3 cases (25%) of high myopic MH after ILMs peeling. Moreover, the residue ERM was observed in nine cases (6.7%) of iERM and two cases (14.3%) in high myopic ERM after ILMs peeling. Some new surgical methods could also be confirmed using iOCT. Conclusion: The application of iOCT has a significant clinical functionality in vitreoretinal surgery, providing the surgeon with a new surgical understanding, guiding the selection of a more reasonable operative procedure during surgery, predicting postoperative recovery and improving postoperative outcomes.

The role of intraoperative optical coherence tomography in pediatric hyphema: a case report

2018 ◽  
Vol 28 (1) ◽  
pp. 127-130 ◽  
Author(s):  
Michele Coppola ◽  
Maria Vittoria Cicinelli ◽  
Alessandro Rabiolo ◽  
Giuseppe Querques ◽  
Francesco Bandello
Keyword(s):  
Optical Coherence Tomography ◽  
Case Report ◽  
General Anesthesia ◽  
Anterior Chamber ◽  
Vitreoretinal Surgery ◽  
Posterior Pole ◽  
Integrated System ◽  
Optical Coherence ◽  
Intraoperative Optical Coherence Tomography

Purpose: Intraoperative optical coherence tomography (iOCT) is a valuable tool during vitreoretinal surgery, helping the decision-making process. It is particularly useful in pediatric cases to evaluate the macular anatomy intraoperatively, avoiding further potentially dangerous surgery in children. The aim of this report is to describe the role of integrated iOCT in the management of traumatic hyphema in a pediatric patient. Case report: A 5-year-old girl was referred to our department with a history of recent domestic trauma in her right eye. Massive bleeding in the anterior chamber without visualization of the posterior segment was evident. Surgery was planned for the next day under general anesthesia. A 25-G irrigation cannula and 25-G vitrectome were inserted at the limbus into the anterior chamber for removal of the anterior chamber clot. Careful inspection of the posterior pole and retinal periphery to exclude pathologic findings was carried out. A real-time OCT integrated system was used to assess the macular anatomy and the corneal state. The postoperative course was uneventful and full visual recovery was achieved. Conclusions: The objective confirmation of macular integrity by means of iOCT after anterior chamber clearing had great prognostic value, excluding the need for surgical revision with a second general anesthesia in this young patient.

scholarly journals Heads-up Digitally Assisted Surgical Viewing with Intraoperative Optical Coherence Tomography for Myopic Schisis Repair

2021 ◽  
Author(s):  
Renato Menezes Palácios ◽  
Kim Vieira Kayat ◽  
Michel Eid Farah ◽  
François Devin
Keyword(s):  
Optical Coherence Tomography ◽  
Vision Loss ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Optical Coherence ◽  
Ilm Peeling ◽  
Intraoperative Optical Coherence Tomography ◽  
Pars Plana ◽  
Foveal Sparing

Purpose: To describe the surgical approach with a screen-based heads-up, threedimensional (3-D) digital viewing with intraoperative optical coherence tomography (IOCT) for the successful repair of a myopic macular schisis (MMS) case. Case Report: A 62-year-old woman with vision loss in the left eye was scheduled for pars plana vitrectomy (PPV) and MMS repair. Surgery was performed using the NGENUITY® system for surgical viewing, and foveal-sparing internal limiting membrane (fs-ILM) peeling was performed without gas tamponade, after confirming the absence of iatrogenic macular hole with I-OCT. There were no intraoperative or postoperative complications. Visual acuity improved to 20/40 and the subfoveal macular thickness improved from 706 μm (preoperative) to 221 μm after seven months of follow-up. Conclusion: Heads-up digitally assisted viewing technology with I-OCT may be useful or preferred for patients requiring vitreoretinal surgery in the setting of MMS.

scholarly journals Intraoperative optical coherence tomography guided corneal sweeping for removal of remnant Interface fluid during ultra-thin Descemet stripping automated endothelial keratoplasty

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Mimouni ◽  
Martin Kronschläger ◽  
Manuel Ruiss ◽  
Oliver Findl
Keyword(s):  
Optical Coherence Tomography ◽  
Retrospective Study ◽  
Optical Coherence ◽  
Endothelial Keratoplasty ◽  
Intraoperative Optical Coherence Tomography ◽  
Graft Thickness

Abstract Background Remnant interface fluid following Descemet stripping automated endothelial keratoplasty (DSAEK) is associated with postoperative detachments. The aim of this study was to assess outcomes of intraoperative optical coherence tomography (iOCT) guided meticulous peripheral corneal sweeping for removal of interface fluid during ultra-thin (UT) DSAEK. Methods This retrospective study included all eyes underwent iOCT guided UT-DSAEK from October 2016 to February 2018 at the Hanusch Hospital, Vienna, Austria. Peripheral meticulous corneal sweeping was performed to remove excess fluid. Central graft thickness (CGT) was measured prior to surgery, after graft bubbling and after corneal sweeping. Remnant interface fluid rates were compared between eyes that underwent rebubbling and those that did not. Results Overall, 28 eyes of 28 patients with a mean age of 73.9 ± 10.0 years were included. An iOCT guided meticulous peripheral sweeping was performed in 89.3% (n = 25) of the cases. Following 84% (n = 21) of the peripheral sweeping performed, remnant fluid was no longer identified. Following peripheral sweeping the interface fluid height was reduced from 17.31 ± 15.96 μm to 3.46 ± 9.52 μm (p < 0.001) and CGT was reduced by 7% (p < 0.001). Rebubbling was performed in 17.9% (n = 5) of the cases. The rebubbling group had a greater proportion of patients that had remnant fluid identified with iOCT at the end of surgery despite meticulous peripheral sweeping (60.0% versus 4.4%, p = 0.01). Conclusion The iOCT identified subclinical remnant fluid in nearly 90% of UT-DSAEK cases. An iOCT guided peripheral corneal sweeping led to resolution of interface fluid in a majority of cases. Eyes with persistent remnant fluid despite peripheral corneal sweeping are more likely to require subsequent rebubbling.

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