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Real-Time (iOCT) Guided Epiretinal Membrane Surgery Using a Novel Forceps with Laser-Ablated Microstructure Tip
Agharza Ashurov1, Argyrios Chronopoulos1, Julia Heim1
1Department of Ophthalmology, Hospital of Ludwigshafen, Teaching Hospital of the University of Johannes Gutenberg-University Mainz and Medical Faculty of the University of Mannheim, 67063 Ludwigshafen, Germany.
Novel forceps and intraoperative OCT (iOCT) successfully guided epiretinal membrane (ERM) and internal limiting membrane (ILM) removal. This technique reduced surgical maneuvers and retinal damage, improving visual acuity and retinal thickness.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Surgical Technology
Background:
- Epiretinal membrane (ERM) and internal limiting membrane (ILM) disorders affect visual quality.
- Current surgical techniques for ERM/ILM removal carry risks of retinal damage.
- Novel instrumentation and imaging are needed to improve surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of intraoperative OCT (iOCT)-guided ERM and ILM removal using novel forceps.
- To assess the safety and effectiveness of forceps with laser-ablated tip surfaces designed to minimize tissue trauma.
- To determine if this combined approach reduces surgical complications and improves visual outcomes.
Main Methods:
- Retrospective analysis of patients undergoing 23- and 25-gauge pars plana vitrectomy (PPV).
- iOCT guidance was used with novel ILM forceps featuring texturized, laser-ablated tips.
- Postoperative video analysis assessed grasping attempts, mobilization, and retinal damage.
Main Results:
- Successful ERM/ILM removal in all cases, with an average of four grasps for initial mobilization.
- Mean best-recorded visual acuity improved (logMAR 0.5 to 0.33, p=0.05).
- Mean central retinal thickness decreased (462 µm to 359 µm, p=0.002), with minor retinal hemorrhage in 22% but no retinal breaks.
Conclusions:
- Texturized ILM forceps facilitate membrane edge mobilization.
- iOCT enhances intraoperative visualization of retinal tissues.
- The combination of iOCT and novel forceps reduces surgical maneuvers and retinal damage.
