How has intraoperative OCT improved outcomes in epiretinal membrane surgery?

Area of Science:

• Ophthalmology
• Surgical Technology
• Retinal Surgery

Background:

• Epiretinal membrane (ERM) surgery aims to improve vision by removing the membrane from the retinal surface.
• Conventional surgical techniques rely on the surgeon's direct visualization.
• Intraoperative optical coherence tomography (iOCT) offers real-time imaging of retinal layers during surgery.

Purpose of the Study:

• To compare functional and anatomical outcomes of iOCT-guided versus conventional ERM surgery.
• To evaluate the role and impact of iOCT in epiretinal membrane surgery.

Main Methods:

• Retrospective review of 62 patients undergoing pars plana vitrectomy (PPV) or combined PPV with cataract extraction for idiopathic ERM.
• Patients were divided into two groups: iOCT-guided surgery (n=29) and conventional surgery (n=31).
• Comparison of preoperative and 12-month postoperative best-corrected visual acuity (BCVA), central foveal thickness (CFT), ellipsoid zone defect (EZD), and foveal contour.

Main Results:

• No significant difference in anatomical outcomes (CFT, EZD) between iOCT-guided and conventional ERM surgery.
• The iOCT group showed a trend towards improved functional outcomes, with better postoperative BCVA compared to the conventional group, although not statistically significant.
• Significant improvement in the nature of the foveal contour was observed in the iOCT-guided group.

Conclusions:

• iOCT integration into surgical microscopes provides enhanced perioperative visualization of retinal structures and tissue interactions.
• While iOCT did not yield statistically significant differences in anatomical results for ERM surgery, it demonstrated potential for improving functional outcomes.
• iOCT facilitates visualization of ERM and associated traction, potentially aiding surgical decision-making and improving patient outcomes.