Download PDF
Klin Monbl Augenheilkd 2020; 237(10): 1220-1224
DOI: 10.1055/a-1193-9045
Übersicht

Stellenwert der intraoperativen optischen Kohärenztomografie in der Netzhautchirurgie. Teil 1: pro

The Role of Intraoperative Microscope-Integrated OCT in Retinal Surgery. Part 1: Pro
Lars-Olof Hattenbach
Augenklinik, Klinikum der Stadt Ludwigshafen gGmbH
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Die intraoperative optische Kohärenztomografie (iOCT) der neuesten Generation bietet durch vollständige Integration der SD-OCT in das OP-Mikroskop erstmals die Möglichkeit einer gezielten hochauflösenden Bildgebung in Echtzeit. Im Vergleich zur konventionellen OP-Mikroskopie wird so eine direkte Befundkontrolle möglich, die für intraoperative Entscheidungen genutzt werden kann. Darüber hinaus gestattet die direkte Einblendung des Live-OCT in das Okular des Mikroskops eine gleichzeitige Darstellung sowohl der mikroskopischen Ansicht als auch der Schichtdarstellung retinaler Mikrostrukturen und damit die präzise Steuerung chirurgischer Manöver. Im Resultat erhält der operative Anwender eine völlig neue Dimension kontrollierter Vitreoretinalchirurgie im Mikrometerbereich.

Abstract

Novel microscope-integrated OCT now allows targeted intraoperative high-resolution real-time imaging. In comparison to conventional surgical microscopes, intraoperative real-time OCT visualisation of retinal layers and vitreous body provides valuable information for surgical decision-making. In addition, simultaneous OCT imaging of retinal structures displayed within the funduscopic view through the eye-piece of the microscope allows direct guidance of instrument-tissue interaction and surgical manoeuvres. As a result, targeted iOCT imaging enables enhanced precision and the development of real-time guided surgical techniques at micron level.

Schlüsselwörter

Retina - intraoperatives Echtzeit-OCT - epiretinale Gliose - Makulaforamen - vitreoretinales Interface

Key words

retina - intraoperative microscope-integrated OCT - macular pucker - macular hole - vitreoretinal interface


Publication History

Received: 12 February 2020

Accepted: 25 March 2020

Article published online:
20 July 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Binder S, Falkner-Radler CI, Hauger C. et al. Feasibility of intrasurgical spectral-domain optical coherence tomography. Retina 2011; 31: 1332-1336
    CrossrefPubMedSearch in Google Scholar
  • 2 Dayani PN, Maldonado R, Farsiu S. et al. Intraoperative use of handheld spectral domain optical coherence tomography imaging in macular surgery. Retina 2009; 29: 1457-1468
    CrossrefPubMedSearch in Google Scholar
  • 3 Ray R, Baranano DE, Fortun JA. et al. Intraoperative microscope-mounted spectral domain optical coherence tomography for evaluation of retinal anatomy during macular surgery. Ophthalmology 2011; 118: 2212-2217
    CrossrefPubMedSearch in Google Scholar
  • 4 Ehlers JP, Tao YK, Srivastava SK. The value of intraoperative optical coherence tomography imaging in vitreoretinal surgery. Curr Opin Ophthalmol 2014; 25: 221-227
    CrossrefPubMedSearch in Google Scholar
  • 5 Ehlers JP, Goshe J, Dupps WJ. et al. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results. JAMA Ophthalmol 2015; 133: 1124-1132
    CrossrefPubMedSearch in Google Scholar
  • 6 Ehlers JP, Tao YK, Farsiu S. et al. Integration of a spectral domain optical coherence tomography system into a surgical microscope for intraoperative imaging. Invest Ophthalmol Vis Sci 2011; 52: 3153-3159
    CrossrefPubMedSearch in Google Scholar
  • 7 Ehlers JP, Tao YK, Farsiu S. et al. Visualization of real-time intraoperative maneuvers with a microscope-mounted spectral domain optical coherence tomography system. Retina 2013; 33: 232-236
    CrossrefPubMedSearch in Google Scholar
  • 8 Hattenbach LO, Framme C, Junker B. et al. Intraoperative real-time OCT in macular surgery. Ophthalmologe 2016; 113: 656-662
    CrossrefPubMedSearch in Google Scholar
  • 9 Junker B, Maier M, Agostini H. et al. [Intraoperative optical coherence tomography in retinal detachment]. Ophthalmologe 2016; 113: 663-667
    CrossrefPubMedSearch in Google Scholar
  • 10 Falkner-Radler CI, Glittenberg C, Gabriel M. et al. Intrasurgical microscope-integrated spectral domain optical coherence tomography-assisted membrane peeling. Retina 2015; 35: 2100-2106
    CrossrefPubMedSearch in Google Scholar
  • 11 Khan M, Ehlers JP. Clinical utility of intraoperative optical coherence tomography. Curr Opin Ophthalmol 2016; 27: 201-209
    CrossrefPubMedSearch in Google Scholar
  • 12 Siebelmann S, Steven P, Cursiefen C. [Intraoperative optical coherence tomography in deep anterior lamellar keratoplasty]. Klin Monatsbl Augenheilkd 2016; 233: 717-721
    Thieme ConnectPubMedSearch in Google Scholar
  • 13 Hattenbach LO, Höhn F, Fulle G. et al. [Preoperative assessment of topographic features in macular pucker using high-definition optical coherence tomography]. Klin Monatsbl Augenheilkd 2009; 226: 649-653
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Michalewska Z, Michalewski J, Adelman RA. et al. Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology 2010; 117: 2018-2025
    CrossrefPubMedSearch in Google Scholar
  • 15 Maier M, Abraham S, Frank C. et al. [Therapeutic options in vitreomacular traction with or without a macular hole]. Klin Monatsbl Augenheilkd 2016; 233: 622-630
    Thieme ConnectPubMedSearch in Google Scholar