[Intraoperative optical coherence tomography in corneal and glaucoma surgical procedures]

Area of Science:

• Ophthalmology
• Surgical Imaging
• Medical Technology

Background:

• Optical coherence tomography (OCT) is the gold standard for anterior and posterior segment imaging.
• OCT integration into surgical microscopes enables intraoperative use in anterior segment surgery.
• OCT excels at imaging thin or transparent structures crucial in corneal and glaucoma procedures.

Purpose of the Study:

• To provide an overview of the opportunities offered by intraoperative OCT in cornea and glaucoma surgery.
• To highlight the advantages of intraoperative OCT over standard surgical microscopes.

Main Methods:

• Analysis of recent literature from PubMed.
• Inclusion of own clinical experience from the Center for Ophthalmology, University Hospital of Cologne.

Main Results:

• Intraoperative OCT provides real-time imaging during corneal and glaucoma surgeries.
• Clinical studies demonstrate benefits in procedures like DMEK, DALK, DSAEK, Boston Keratoprosthesis, canaloplasty, and trabectome surgery.
• OCT visualizes structures not discernible with a standard surgical microscope.

Conclusions:

• Intraoperative OCT offers high-resolution, real-time imaging, delivering supplementary information in glaucoma and corneal surgery.
• Shadowing from surgical instruments presents a significant challenge.
• A primary limitation is the current scarcity of randomized-controlled trials evaluating microscope-integrated intraoperative OCT's benefits.