How has intraoperative OCT improved outcomes in epiretinal membrane surgery?
Purpose: To compare the functional and anatomical outcomes of patients who underwent intraoperative optical coherence tomography (iOCT)-guided or conventional epiretinal membrane (ERM) surgery and to assess the role of iOCT in ERM surgery. Methods: The medical records of patients who underwent pars...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Photodiagnosis and Photodynamic Therapy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1572100025001152 |
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| Summary: | Purpose: To compare the functional and anatomical outcomes of patients who underwent intraoperative optical coherence tomography (iOCT)-guided or conventional epiretinal membrane (ERM) surgery and to assess the role of iOCT in ERM surgery. Methods: The medical records of patients who underwent pars plana vitrectomy (PPV) or a combined surgery (PPV + cataract extraction) for idiopathic ERM were reviewed retrospectively (n = 62). The patients were divided into two groups: Group 1(n = 29) underwent iOCT guided surgery and Group 2 (n = 31) underwent conventional surgery. Pre- and postoperative 12th month best corrected visual acuity (BCVA), central foveal thickness (CFT), ellipsoid zone defect (EZD), and nature of foveal contour were compared. Results: The mean age was 69.58 ± 5.69 (60–81) years in Group 1 and 73.33 ± 6.74 (56–83) years in Group 2 (p = 0.022). There was no significant difference in the Female/Male ratio, lens status (phakic or pseudophakic), and type of surgery (PPV or PPV + cataract extraction) between the two groups (p > 0.05 for all). The preoperative and postoperative mean BCVA was 0.30 ± 0.21 (0.005–0.7) and 0.47 ± 0.31 (0.016–1) (p < 0.001) respectively in Group 1, and 0.21 ± 0.16 (0.001–0.7) and 0.30 ± 0.25 (0.008–1) (p = 0.385), respectively in Group 2. The preoperative and postoperative mean CFT was 495.2 ± 128.7 (301–763) µm and 339.1 ± 97.6 (193–545) µm in Group 1 (p < 0.001) and 555.1 ± 96.9 (362–807) µm and 400.1 ± 67.69 (246–637) µm in Group 2, respectively (p < 0.001). The decrease in mean CFT was similar between the two groups (p = 0.749). Although pre- and postoperative EZD were similar, the nature of the foveal contour was significantly improved in Group 1. Conclusion: Integrating OCT into the operating microscope provides perioperative visualization of the retinal layers, vitreous, and vitreomacular interface; moreover, it enables instrument-tissue interactions. ERM and secondary traction to the membrane can be easily visualized with iOCT. Although the use of iOCT did not lead to a statistically significant difference in anatomical results, it could improve functional outcomes. |
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| ISSN: | 1572-1000 |