What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review.

Chiara Posarelli,Andrea Passani,Giovanna Vella,Francesco Sartini,Michele Figus,Giamberto Casini,Mario Damiano Toro

doi:10.3390/jcm9061682

Abstract

Background: Optical coherence tomography (OCT) has recently been introduced in the operating theatre. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Method: A total of 314 studies were identified, following a literature search adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. After full-text evaluation, 81 studies discussing MI-OCT applications in ophthalmology were included. Results: At present, three microscope-integrated optical coherence tomography systems are commercially available. MI-OCT can help anterior and posterior segment surgeons in the decision-making process, providing direct visualization of anatomic planes before and after surgical manoeuvres, assisting in complex cases, and detecting or confirming intraoperative complications. Applications range from corneal transplant to macular surgery, including cataract surgery, glaucoma surgery, paediatric examination, proliferative diabetic retinopathy surgery, and retinal detachment surgery. Conclusion: The use of MI-OCT in ophthalmic surgery is becoming increasingly prevalent and has been applied in almost all procedures. However, there are still limitations to be overcome and the technology involved remains difficult to access and use.

Highlights

Optical coherence tomography (OCT) is a non-contact imaging technique which uses low-coherence interferometry to detect photons backscattered from biological tissues, visualizing a cross-sectional map with micrometre spatial resolution [1]
After full-text evaluation, 82 studies discussing the use of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology were included [13,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98]
The included studies were grouped considering the application of MI-OCT during anterior or posterior segment surgery, as listed in the Supplementary Materials

Summary

Introduction

Optical coherence tomography (OCT) is a non-contact imaging technique which uses low-coherence interferometry to detect photons backscattered from biological tissues, visualizing a cross-sectional map with micrometre spatial resolution [1]. The first intraoperative OCT use was reported in 2005 by Geerling et al, in which a time domain anterior segment OCT (4 optics, Lübeck, Germany) was coupled with a beam splitter on the front lens of a surgical microscope [2]. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Results: At present, three microscope-integrated optical coherence tomography systems are commercially available. MI-OCT can help anterior and posterior segment surgeons in the decision-making process, providing direct visualization of anatomic planes before and after surgical manoeuvres, assisting in complex cases, and detecting or confirming intraoperative complications. There are still limitations to be overcome and the technology involved remains difficult to access and use

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Conclusion