[Intraoperative Optical Coherence Tomography in Vitreoretinal Surgery: Clinical Experiences and Future Developments]

Area of Science:

• Ophthalmology
• Medical Imaging
• Surgical Technology

Background:

• High-resolution optical coherence tomography (OCT) offers superior visualization of ophthalmic microstructures compared to conventional imaging.
• Integrated OCT (iOCT) into ophthalmic microscopes allows for high-resolution, real-time visualization during procedures.

Purpose of the Study:

• To report on the initial clinical application of microscope-integrated OCT (iOCT) in posterior segment surgeries.
• To evaluate the utility of iOCT in real-time surgical guidance and decision-making.

Main Methods:

• A cohort of 110 patients undergoing posterior segment surgery utilized a microscope with integrated OCT (iOCT).
• iOCT was employed to visualize microstructural changes and retinal anatomy during surgical interventions.

Main Results:

• iOCT precisely depicted microstructural changes occurring during surgery.
• Real-time visualization of retinal morphology enabled surgeons to adapt surgical flow and tailor procedures.
• iOCT data facilitated patient- and operation-specific interventional strategies.

Conclusions:

• Current iOCT systems lack measurement, tracking, and autofocus capabilities, and are hindered by metal instruments.
• Future advancements including OCT-friendly surgical tools, tracking, autofocus, and higher resolution are needed for comprehensive intraoperative diagnostics.