Eyeworld

119 EW RETINA September 2016 imaging during canaloplasty. J Glaucoma. 2016;25:236–8. 2. Saad A, et al. Intraoperative OCT-assist- ed DMEK: 14 consecutive cases. Cornea. 2015;34:802–7. 3. De Benito-Llopis L, et al. Intraoperative an- terior segment optical coherence tomography: a novel assessment tool during deep anterior lamellar keratoplasty. Am J Ophthalmol. 2014;157:334–341. 4. Steven P, et al. Optimising deep anterior lamellar keratoplasty (DALK) using intraop- erative online optical coherence tomography (iOCT). Br J Ophthalmol. 2014;98:900–4. 5. Ehlers JP. Intraoperative optical coherence tomography: past, present, and future. Eye (Lond). 2016;30:193–201. 6. Ehlers JP, et al. The prospective intraoper- ative and perioperative ophthalmic imaging with optical coherence tomography (PIONEER) study: 2-year results. Am J Ophthalmol. 2014;158:999–1007. 7. Ehlers JP, et al. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results. JAMA Ophthalmol. 2015;133:1124–32. 8. Cost B, et al. Intraoperative optical coherence tomography-assisted Descemet membrane endothelial keratoplasty in the DISCOVER study. Am J Ophthalmol. 2015;160:430–7. 9. Au J, et al. Intraoperative optical coherence tomography for enhanced depth visualization in deep anterior lamellar keratoplasty from the PIONEER study. Cornea. 2015;34:1039–43. 10. Hirnschall N, et al. Predicting the postoperative intraocular lens position using continuous intraoperative optical coherence tomography measurements. Invest Ophthamol Vis Sci. 2013;54:5196–5203. 11. Lytvynchuk LM, et al. Evaluation of intraocular lens position during phacoemulsi- fication using intraoperative spectral-domain optical coherence tomography. J Cataract Refract Surg. 2016;42:694–702. Editors' note: Dr. Ehlers has financial interests with Alcon (Fort Worth, Texas), Bioptigen (Morrisville, North Carolina), Carl Zeiss Meditec, Genentech (South San Francisco), Leica Microsystems, Regeneron (Tarrytown, New York), Santen (Osaka, Japan), Synergetics (St. Louis), and ThromboGenics (Leuven, Belgium). Drs. Lisa and Lane have no financial interests related to their comments. Contact information Ehlers: EHLERSJ@ccf.org Lane: sslane@associatedeyecare.com Lisa: carloslisa@fernandez-vega.com if there is a correlation between the type of IOL and the size of the bag, which could lead to a new set of parameters and designs for IOLs. Dr. Lisa told EyeWorld he uses intraoperative OCT in all of his pha- kic implantable contact lens (ICL) surgeries. "It is very useful in case of high- er vaults during ICL implantation because we can solve them rotating the ICL to the vertical position," he said. Dr. Ehlers said that while there is real opportunity when it comes to intraoperative OCT and lens posi- tioning/calculations, the technology is still in the early stages for this application. "Many systems that are avail- able don't have the range to go from the anterior cornea to poste- rior capsule to be able to make that calculation. In addition, a rapid software platform for performing the calculations is not currently avail- able. It's not very feasible right now, but it's something to be looking for in the future to see how it evolves," Dr. Ehlers said. Software improvements as well as surgical instruments that are OCT compatible are of interest to help improve the utility of OCT in the OR as well, Dr. Ehlers said. "We also need more long- term outcome information. I think it's pretty clear that having more information in the OR does impact surgical decision-making. What isn't currently clear is whether that impact on surgical decision-making truly changes how a patient does postoperatively. That is something our group and other groups are working on, including a potential randomized controlled trial." There are currently three systems approved by the U.S. Food and Drug Administration (FDA) for integrated use with an OR micro- scope: EnFocus (Leica Microsystems, Buffalo Grove, Illinois), which can be mounted and later removed from the microscope; RESCAN 700, which is integrated into the LUMERA 700 microscope system (Carl Zeiss Med- itec); and iOCT (Haag-Streit, Koniz, Switzerland), which is integrated into the HS Hi-R NEO 900A NIR. EW References 1. Siebelmann S, et al. Intraoperative optical coherence tomography enables noncontract

• Cover