Anatomical Changes of Full-Thickness Macular Hole Documented by Microscope-Integrated Spectral-Domain Optical Coherence Tomography

González-Cortés, Jesús Hernán; Estudillo, A. Ramírez; Sánchez-Ramos, Jorge Arturo; Bages-Rousselon, Yunuen; Fernandez-Mar, Mariana; Mohamed-Hamsho, Jesús

doi:10.3928/23258160-20180907-17

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…The added value is considered less in straightforward surgery, but increases when difficult anterior chamber conditions exist, such as a shallow anterior chamber, synechiae or reduced vision due to corneal oedema. A vast amount of case reports for complex and difficult cases in which iOCT proved decisive and improved surgical decision‐making show the value of iOCT (Coppola et al, 2018; Gonzalez‐Cortes et al, 2018; Hartmann et al, 2020; Lim et al, 2022; Lytvynchuk et al, 2017; Muijzer, Schellekens, et al, 2022). Lastly, promising innovations are being developed which are dependent on the availability of iOCT (e.g.…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of the ADVISE trial: An intraoperative OCT protocol in DMEK surgery

Zee

Muijzer

Biggelaar

et al. 2023

Acta Ophthalmologica

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The intraoperative optical coherence tomography (iOCT) is recently introduced in Descemet membrane endothelial keratoplasty (DMEK) surgery, which aims to increase clinical performance and surgery safety. However, the acquisition of this modality is a substantial investment. The objective of this paper is to report on the cost‐effectiveness of an iOCT‐protocol in DMEK surgery with the Advanced Visualization in Corneal Surgery Evaluation (ADVISE) trial. This cost‐effectiveness analysis uses data 6 months postoperatively from the multicentre prospective randomized clinical ADVISE trial. Sixty‐five patients were randomized to usual care (n = 33) or the iOCT‐protocol (n = 32). Quality‐Adjusted Life Years (EQ‐5D‐5L), Vision‐related Quality of Life (NEI‐VFQ‐25) and self‐administered resources questionnaires were administered. Main outcome is the incremental cost‐effectiveness ratio (ICER) and sensitivity analyses. The iOCT protocol reports no statistical difference in ICER. For the usual care group compared with the iOCT protocol, respectively, the mean societal costs are €5027 compared with €4920 (Δ€107). The sensitivity analyses report the highest variability on time variables. This economic evaluation learned that there is no added value in quality of life or cost‐effectiveness in using the iOCT protocol in DMEK surgery. The variability of cost variables depends on the characteristics of an eye clinic. The added value of iOCT could gain incrementally by increasing surgical efficiency, and aiding in surgical decision‐making.

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Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of the ADVISE trial: An intraoperative OCT protocol in DMEK surgery

Zee

Muijzer

Biggelaar

et al. 2023

Acta Ophthalmologica

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“…22,23 Moreover, the realtime visual feedback of iOCT enhances surgical performance, for example, by showing retinal traction during peeling. 16,18,19,[24][25][26][27][28][29] Nonetheless, iOCT is relatively new for us, and, owing to its high cost, it would not be always available in some of institutions. In addition, the edge of ERM has to be analyzed by continuous iOCT video in a cross-sectional view for peeling to start, whereas it could be detected with just one shot on MC-SLO with an en face view.…”

Section: The Advantages Of Mc-slo In the Management Of Erm Surgery Compared With Ioct And En Face Octmentioning

confidence: 99%

Multicolor Scanning Laser Ophthalmoscopy Strengthens Surgeons’ Preoperative Decision-Making and Intraoperative Performance on Epiretinal Membrane

Zhang

Wen

Sun

et al. 2020

Trans. Vis. Sci. Tech.

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Purpose To determine whether multicolor scanning laser ophthalmoscopy (MC-SLO) was better than color fundus photography (CFP) to enhance residents and specialists’ preoperative decision-making and intraoperative performance on the epiretinal membrane (ERM). Methods Consecutive patients with idiopathic ERM were recruited prospectively. All the patients underwent MC-SLO and CFP imagings and were randomized into MC-SLO (n = 20) and CFP (n = 20) groups. Preoperatively, residents and specialists were required to have ERM delineation and select an optimal location for initial ERM peeling independently, based on the MC-SLO (MC-SLO group) or CFP (CFP group) images. Intraoperative optical coherence tomography (iOCT) was introduced to evaluate the accuracy. Results Preoperatively, residents and specialists acted more effectively in ERM delineation and selection of initial grasping location in the MC-SLO group (both P < 0.001). In the MC-SLO group, higher resident–specialist agreements were achieved in ERM delineation ( P = 0.002) and selection of initial grasping location ( P = 0.035). The iOCT revealed greater interobserver (iOCT–resident and iOCT–specialist) agreements of ERM delineation in MC-SLO group ( P < 0.001 and = 0.027, respectively). Surgeons acted more effectively on completely peeling the ERM in the MC-SLO group ( P < 0.001). Conclusions MC-SLO provided a better visual reference for residents and specialists in ERM delineation and the selection of an initial grasping location for the surgery, compared with CFP. Translational Relevance MC-SLO is able to help surgeons achieve better intraoperative performance and shorten the learning process for residents.

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“…Macular holeThe dynamic nature of the internal limiting membrane (ILM) peeling has been evidenced with MIOCT[39,46]. Modifications of the retinal ultrastructure and geometry of MH during the ILM peeling have been described[17, 31, 42,[47][48][49].…”

mentioning

confidence: 99%

“…Modifications of the retinal ultrastructure and geometry of MH during the ILM peeling have been described[17, 31, 42,[47][48][49]. Assessment of the border of the ILM peeling(Figure 2), residual ILM, retinal trauma(Figure 3), and anatomical closure(Figure 4)can be easily made in a real-time fashion[39,46]. A volume increase and base area increase of MH, with a concurrent decrease in the apex height, have been evidenced following ILM peeling…”

mentioning

confidence: 99%

“…Surgical implications of microscope-integrated optical coherence tomography. Microscope-Integrated Intraoperative Optical Coherence Tomography in Retinal Surgery DOI: http://dx.doi.org/10.5772/intechopen.83511[39,46,47,50]. Additionally, the distance between ellipsoid zone and RPE and the lateral extension of this expansion have been documented and associated with anatomical and functional outcomes[16, 17, 41, 42,47,[50][51][52].…”

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confidence: 99%

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Microscope-Integrated Intraoperative Optical Coherence Tomography in Retinal Surgery

González-Cortés¹,

Olvera-Barrios²,

Gonzalez-Cantu³

et al. 2019

Novel Diagnostic Methods in Ophthalmology

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Imaging techniques of the posterior segment of the eye have gradually evolved and tremendously improved during the last decade. A widespread implementation of optical coherence tomography (OCT) for the management and diagnosis of retinal conditions, with a concurrent advance in integrative technology, led to the integration of the OCT into the microscope for its intraoperative use. Regarding posterior segment eye surgery, some of the most common diagnoses in which microscope-integrated OCT (MIOCT) can result of great value are epiretinal membrane, macular hole (MH), proliferative diabetic retinopathy (PDR) and, less frequently, for inflammatory diseases, chorioretinal biopsies, and retinal implants. The impact on the surgical procedure and, possibly, on the postoperative outcome could relate to the definition of whether or not a membrane has been entirely peeled, the presence of residual membranes, and the option to perform a dissection without the need of vital dyes. The possibility of correct topographical location of hemorrhages, suspect lesions, or implants can also facilitate the surgical decision-making during biopsies or prosthesis implantation. Microscope-integrated OCT is a feasible and useful tool that can provide valuable information during surgery impact on decision-making, anatomic results, surgical safety and provide opportunity to individualize surgical treatment for each patient.

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Anatomical Changes of Full-Thickness Macular Hole Documented by Microscope-Integrated Spectral-Domain Optical Coherence Tomography

Cited by 4 publications

References 41 publications

Cost‐effectiveness of the ADVISE trial: An intraoperative OCT protocol in DMEK surgery

Cost‐effectiveness of the ADVISE trial: An intraoperative OCT protocol in DMEK surgery

Multicolor Scanning Laser Ophthalmoscopy Strengthens Surgeons’ Preoperative Decision-Making and Intraoperative Performance on Epiretinal Membrane

Microscope-Integrated Intraoperative Optical Coherence Tomography in Retinal Surgery

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