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      Intraoperative Optical Coherence Tomography Guided Ocular Surgeries: Critical Analysis of Clinical Role and Future Perspectives

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          Abstract

          Intraoperative imaging of ocular tissues for diagnostic and therapeutic applications has gained immense admiration in recent years. The real time cross-sectional imaging, as well as three and four dimensional reconstruction abilities of intraoperative optical coherence tomography (iOCT), has enhanced our knowledge on many fronts in surgical maneuvers. In this review, we discuss the iOCT discovered constructive knowledge in the cornea, cataract, refractive, glaucoma, pediatric ocular, and various retinal conditions. The practical utility with decision modifying aspects along the specified ocular tissues and with respect to specific ocular entities have been narrated. Moreover, limitations and future directions have also been emphasized to make ophthalmic care more comprehensive in the future.

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          The Prospective Intraoperative and Perioperative Ophthalmic ImagiNg with Optical CoherEncE TomogRaphy (PIONEER) Study: 2-year results.

          Justis P Ehlers, William J Dupps, Peter K Kaiser … (2014)
          To evaluate the feasibility, safety, and utility of intraoperative optical coherence tomography (OCT) for use during ophthalmic surgery.
          Article 0 comments Cited 53 times – based on 0 reviews     Review now
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            Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results.

            Justis P Ehlers, Jeff Goshe, William J Dupps … (2015)
            Optical coherence tomography (OCT) has transformed the clinical management of a myriad of ophthalmic conditions. Applying OCT to ophthalmic surgery may have implications for surgical decision making and patient outcomes.
            Article 0 comments Cited 51 times – based on 0 reviews     Review now
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              Optimizing descemet membrane endothelial keratoplasty using intraoperative optical coherence tomography.

              Claus Cursiefen, Gereon Hüttmann, Stefan Oelckers … (2013)
              Descemet membrane endothelial keratoplasty (DMEK) is a challenging procedure for the surgeon, particularly because of deficient visibility of the delicate tissue due to the natural en face view through the operating microscope. A cross-sectional view would greatly enhance intraoperative overview and enable the surgeon to better control the procedure. To retrospectively analyze the use of intraoperative optical coherence tomography (iOCT) for improving the safety of DMEK. Intraoperative OCT during DMEK was performed in 26 eyes of 26 patients. We retrospectively analyzed imaging and video data. Department of Ophthalmology, University of Cologne. Seven men and 19 women aged 39 to 93 years with corneal endothelial dysfunction undergoing DMEK. Descemet membrane endothelial keratoplasty. Visibility of surgical steps, overall duration of DMEK, overall time for complete intraoperative air filling of the anterior chamber, and correlation between donor age and Descemet rolling behavior. RESULTS Intraoperative OCT enables visualization of all steps of the DMEK procedure. Overall mean (SD) duration of the DMEK procedure was 25.7 (6.9) minutes when using iOCT. Overall mean (SD) complete intraoperative anterior chamber air-filling time was 236 (108) seconds in contrast to 60 to 90 minutes for standard air-filling time. Descemet membrane rolling behavior showed significant inverse correlation between donor age (range, 39-93 years) and the extent of rolling (R2 = 0.5 [P = .006]). Intraoperative OCT enhances the visibility of graft orientation and unfolding, thereby improving safety of the DMEK procedure. Overall, iOCT is a helpful device that may support surgeons in all steps of DMEK procedures.
              Article 0 comments Cited 42 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): opth
                Journal ID (pmc): clinop
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 24 August 2020
                Publication date Collection: 2020
                Volume: 14
                Pages: 2427-2440
                Affiliations
                [1 ]Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences , New Delhi, India
                Author notes
                Correspondence: Amar Pujari Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences , New Delhi, IndiaTel +91 8447226221 Email dramarpujari@gmail.com
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0002-1939-3938
                http://orcid.org/0000-0002-2124-7542
                Article
                Publisher ID: 270708
                DOI: 10.2147/OPTH.S270708
                PMC ID: 7457570
                SO-VID: 46eb82a9-8880-42b1-a519-4a1b069ac250
                Copyright © © 2020 Pujari et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 04 July 2020
                Date accepted : 07 August 2020
                Page count
                Figures: 8, References: 121, Pages: 14
                Categories
                Subject: Review

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: intraoperative optical coherence tomography,ioct,hand-held optical coherence tomography and intraoperative microscope integrated optical coherence tomography
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: intraoperative optical coherence tomography, ioct, hand-held optical coherence tomography and intraoperative microscope integrated optical coherence tomography

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