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| The Role of Intraoperative Optical Coherence Tomography in Guiding Vitreoretinal Surgery |
| Rong Cheng1, Chuan Yu2, Yuqian Wang1, Yuping Duan1, Yao Hu1 |
| 1Wuhan Eyegood Ophthalmic Hospital, Wuhan 430064, China2Department of Ophthalmology, the First Affliated Hospital of Zhengzhou University, Zhengzhou 450052, China |
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Abstract Objective: To evaluate the clinical role of intraoperative optical coherence tomography (iOCT) in guiding vitreoretinal surgeries. Methods: A retrospective series of case study. From February 2021 to December 2021, total 82 patients (82 eyes) who underwent vitreoretinal surgery due to macular hole, epimacular membrane, vitreous hemorrhage and other diseases in Wuhan Eyegood Ophthalmic Hospital were included in this study. All eyes were operated by the same surgeon for 25G vitrectomy, with iOCT scanning recording the preoperative, intraoperative and postoperative changes of retinal structure in the macular area. Analyze the consistency between the operator's observations under the microscope and the scanning images presented by iOCT. Results: Forty-two males and 40 females were included in this study, with ages ranging from 35 to 78 (63.0±7.0). Twenty-fve eyes (30%) were preoperatively diagnosed with epimacular membrane, 16 eyes (20%) with macular hole, 13 eyes (16%) with macular foveoschisis, 25 eyes (30%) with vitreous hemorrhage, and 3 eyes (4%) with vitreomacular traction syndrome. For cases with macular surgery, dynamical changes were observed during the whole operation. The etiologies of vitreous hemorrhage included proliferative diabetic retinopathy (12 eyes), retinal vein occlusion (7 eyes), retinal hole (3 eyes), retinal arterial macro aneurysm (2 eyes), and polypoid choroidal vasculopathy (1 eye). Nineteen cases showed structural abnormalities in the macular area on iOCT scanning, including macular edema (10 eyes), epimacular membrane (5 eyes), macular edema with epimacular membrane (2 eyes), and macular atrophy (2 eyes). Total 69 eyes (84%) showed consistent results between the operator's observation under the microscope and the iOCT image, and other 13 eyes (16%) showed inconsistency. Eventually 11 eyes (13%) were received the changed treatment strategy based on iOCT scanning results, including 4 eyes with macular hole, 3 eyes with epimacular membrane, and 4 eyes with vitreous hemorrhage. Conclusions:iOCT provides a clearly real-time dynamic observation of the intraoperative retina, especially the fine structure of the macular area, which can promptly guide the surgeon to choose a more suitable surgical method.
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Received: 07 March 2023
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Corresponding Authors:
Yao Hu, Email:35241687@qq.com
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