The advent of Optical Coherence Tomography (OCT) in ophthalmology brought a more accurate diagnosis, earlier detection of disease, and more fine-tuned treatment of individual patients’ diseases. Evidence has demonstrated that intraoperative OCT (iOCT) can provide surgeons with crucial imaging of structures below the visible surface.

OCT microscope

The DISCOVER study was created to evaluate iOCT in eye surgeries. Preliminary results from the study were recently published in the British Journal of Ophthalmology. These results looked at how a specific iOCT system (RESCAN 700) was used in 10 surgeries. The RESCAN 700 features a heads-up display and foot controls for ease of use. In addition, the OCT engine is integrated with the microscope (as opposed to an external housing). The minimal changes to the microscope allows for a small footprint in the operating room where real estate is at a premium.

This system is the first with a heads-up display to be used in human applications. This type of display is important, because it allows the surgeon to see the image while continuing to look where they normally would during these procedures (in the eyepiece of their microscope).

OCT in surgery

In surgery, the iOCT was useful in detecting microscopic defects that affected the surgical plan in addition to guiding the surgeon in real time. In image B above, the yellow arrow is pointing at a full-thickness macular hole that was seen during surgery. This discovery caused the surgeon to alter the original plan. In images C and D above, you can see the microscopic and iOCT views of a surgeon’s tool during a procedure. On the left, you can see the instrument entering the surface of the retina. On the right, you can see how the instrument is interacting with the underlying tissue.

The development of iOCT for use in ophthalmologic surgery is exciting due to the increased precision that it will provide. Patients will have higher quality surgeries that are likely to have decreased adverse outcomes. Beyond that, it will be exciting to see how this technology leads to the development of methodologies using OCT elsewhere in the body.

Source: British Journal of Ophthalmology