Eyeworld

EW INTERNATIONAL 68 April 2018 by Liz Hillman EyeWorld Staff Writer all impact on surgical decision-mak- ing and perceived value," Dr. Ehlers said. Overall, Dr. Ehlers said proce- dures that might particularly benefit from iOCT with current technology include lamellar keratoplasty (e.g., DMEK, DSAEK), membrane peeling, and vitrectomy for proliferative dia- betic retinopathy sequelae, to name a few. Dr. Ehlers said a randomized controlled clinical trial examining some of these procedures with iOCT would be useful. "We are currently planning a multicenter clinical trial for examin- ing iOCT for various retinal surgi- cal indications. These trials would provide more definitive information regarding the overall impact of iOCT on surgical outcomes," Dr. Ehlers said. "At this time, I think the major driver around adoption of this technology is cost. As the cost of iOCT comes down, I think we will see more broad utilization of this technology. Additional research is also needed to improve image qual- ity, maximize the surgeon feedback system (e.g., improving heads-up display, 3-D surgical solutions, automated tracking), provide new innovations in software platforms for analysis, and enhance new OCT- compatible instrumentation." Separately, swept source OCT (SS-OCT) has already demonstrat- ed its ability to image through the length of the eye, but as Ireneusz Grulkowski, PhD, assistant profes- sor, faculty of physics, astronomy and informatics, Institute of Physics, Nicolaus Copernicus University, Torun, Poland, put it, the optics of the eye made it impossible to scan the retina and the anterior segment at the same time. Recent research by Grulkowski et al. described an SS-OCT technol- ogy with a tunable lens that quickly changes focusing capabilities al- lowing it, as a single instrument, to image from the anterior to posterior segment in one sitting. 2 Grulkowski et al. described the incorporation and testing of an elec- tronically tunable lens with a long- range SS-OCT system in the journal Optica. The technology draws its inspiration from smartphones, Dr. Grulkowski told EyeWorld. Research shows surgical impact of intraoperative OCT and technological advancement to image the whole eye O ptical coherence tomogra- phy (OCT) is continuing its technological advance- ment and demonstrating its value intraoperatively, according to recent studies. Three-year study results show- ing the feasibility and usefulness of intraoperative OCT (iOCT) during surgery were recently published by Ehlers et al. in the journal Oph- thalmology. 1 The Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/ Integrated OCT Visualization during En Face Retinal and Ophthalmic Surgery (DISCOVER) study involved 244 anterior segment procedures and 593 posterior segment proce- dures (837 total) with successful OCT imaging in 820 eyes. The intraoperative imaging made avail- able by the OCT impacted surgical decision-making in 106 anterior segment and 173 posterior segment cases. "The use of OCT in the operat- ing room is still an emerging field, and the role for OCT for various procedures and indications may be quite different," said Justis P. Ehlers, MD, director, Tony and Leona Campane Center for Excellence in Image-Guided Surgery & Advanced Imaging Research, Cole Eye Insti- tute, Cleveland Clinic, Cleveland. "Utilizing this approach, we were able to examine a large number of cases across multiple surgical indi- cations and surgical procedures. Ad- ditionally, we were able to evaluate changes to surgeon utilization and impression over time." Dr. Ehlers said he and his coau- thors were not sure what to expect for the results at the outset of the study. Based on previous studies, they did expect some impact on sur- gical decision-making, but they were not sure of the magnitude. "What was particularly inter- esting in this study was that the findings are consistent with multiple previous studies regarding the over- Studies show advances, value in OCT technology Research highlight Pablo Artal, PhD, led the Universidad de Murcia research group that developed a new OCT instrument that can provide a detailed image of the entire eye. The imaging system could allow scientists to better understand how the vitreous gel that fills the eye interacts with the retina and why it can sometimes become detached with aging. Source: Pablo Artal, PhD The new system expands the applications for OCT in ophthalmology. Pictured here: Dr. Grulkowski (right), who led the team at Nicolaus Copernicus University, and graduate student Karol Karnowski Source: Ireneusz Grulkowski, PhD

• Cover
• Blank Page
• Blank Page (1)