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Abstract
PurposeWe investigate acute retinal alterations identified on intraoperative optical coherence tomography (iOCT) immediately following surgical intervention with the Finesse Flex Loop for vitreoretinal interface disorders.MethodsThe Determination of feasibility of Intraoperative Spectral domain microscope Combined/integrated OCT Visualization during En face Retinal and ophthalmic surgery (DISCOVER) study is a prospective multisurgeon intraoperative OCT clinical study. Subjects who had participated in the DISCOVER study and had undergone macular surgery with the membrane flex loop from August 2014 to July 2016 were identified. iOCT images and video sequences were evaluated at various surgical time points. Subjects were excluded if iOCT images were not obtained over the area of membrane peeling performed with the membrane flex loop. Qualitative characteristics of intraoperative changes in retinal images were analyzed, with particular focus on the retinal layers within the bed of membrane peeling performed specifically with the membrane flex loop.ResultsWe studied 34 eyes of 34 patients, with a mean age of 72.7 (± 6.4) years, 25 of whom were women. The intraoperative diagnosis was full thickness macular hole in 21 eyes (62%) and epiretinal membrane in 13 (38%). All eyes had successful indocyanine green–assisted inner limiting membrane (ILM) flap initiation using the membrane loop. Intraoperative OCT demonstrated expansion of the ellipsoid zone-to-RPE distance in 3 eyes (9%), definitive subretinal fluid accumulation in 1 eye (3%), and hyperreflectivity of the inner retinal layers associated with retinal hemorrhage in 10 eyes (29%). Retinal breaks were not observed in any eye.ConclusionsAcute retinal alterations after ILM peeling with the membrane flex loop were visualized at a frequency of less than 10%. Additional research is needed to understand the clinical impact, if any, of these architectural alterations.
Highlights
MethodsThe Determination of feasibility of Intraoperative Spectral domain microscope Combined/integrated OCT Visualization during En face Retinal and ophthalmic surgery (DISCOVER) study is a prospective multisurgeon intraoperative OCT clinical study
We investigate acute retinal alterations identified on intraoperative optical coherence tomography immediately following surgical intervention with the Finesse Flex Loop for vitreoretinal interface disorders
Acute retinal alterations after inner limiting membrane (ILM) peeling with the membrane flex loop were visualized at a frequency of less than 10%
Summary
The Determination of feasibility of Intraoperative Spectral domain microscope Combined/integrated OCT Visualization during En face Retinal and ophthalmic surgery (DISCOVER) study is a prospective multisurgeon intraoperative OCT clinical study. Subjects who had participated in the DISCOVER study and had undergone macular surgery with the membrane flex loop from August 2014 to July 2016 were identified. Subjects were excluded if iOCT images were not obtained over the area of membrane peeling performed with the membrane flex loop. The Determination of feasibility of Intraoperative Spectral domain microscope Combined/integrated OCT Visualization during En face Retinal and ophthalmic surgery (DISCOVER) study is an Internal Review Board (IRB)-approved prospective study examining the feasibility and use of microscopeintegrated iOCT during ophthalmic surgery.[1]. Eyes that underwent membrane peeling procedures using the membrane loop were identified and included in this analysis Intraoperative imaging for this portion of the DISCOVER study was performed using a prototype Rescan 700 (Carl Zeiss Meditec, Oberkochen, Germany) iOCT system integrated on the Lumera 700 (Carl Zeiss Meditec) microscope platform. Exclusion criteria included lack of iOCT images in the area of membrane flex loop peeling or insufficient iOCT quality for interpretation
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