Intraoperative Anterior Segment Optical Coherence Tomography in the Management of Cataract Surgery: State of the Art

Toro, Mario Damiano; Milan, Serena; Tognetto, Daniele; Ręjdak, Robert; Costagliola, Ciro; Zweifel, Sandrine; Posarelli, Chiara; Figus, Michele; Rejdak, Magdalena; Avitabile, Teresio; Carnevali, Adriano; Giglio, Rosa

doi:10.3390/jcm11133867

Cited by 4 publications

(1 citation statement)

References 40 publications

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“…At first, iOCT was employed in vitreoretinal surgery, focusing on macular hole [8,12,13], vitreomacular traction [14,15], epiretinal membrane [16,17], and retinal detachment surgery [18,19]. More recently, it has been applied to glaucoma surgery [20], implantable collamer lens (ICL) implantation [21], cataract surgery [22], and corneal transplantation [23,24]. Concerning corneal surgery, its application is mainly related to lamellar surgery, both anterior and endothelial.…”

Section: Intraoperative Oct: Technology and Characteristicsmentioning

confidence: 99%

Intraoperative OCT for Lamellar Corneal Surgery: A User Guide

Moramarco

Geronimo

Airaldi

et al. 2023

JCM

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Intraoperative OCT is an innovative and promising technology which allows anterior and posterior segment ocular surgeons to obtain a near-histologic cross-sectional and tomographic image of the tissues. Intraoperative OCT has several applications in ocular surgery which are particularly interesting in the context of corneal transplantation. Indeed, iOCT images provide a direct and meticulous visualization of the anatomy, which could guide surgical decisions. In particular, during both big-bubble and manual DALK, the visualization of the relationship between the corneal layers and instruments allows the surgeon to obtain a more desirable depth of the trephination, thus achieving more type 1 bubbles, better regularity of the plane, and a reduced risk of DM perforation. During EK procedures, iOCT supplies information about proper descemetorhexis, graft orientation, and interface quality in order to optimize the postoperative adhesion and reduce the need for re-bubbling. Finally, mushroom PK, a challenging technique for many surgeons, can be aided through the use of iOCT since it guides the correct apposition of the lamellae and their centration. The technology of iOCT is still evolving: a larger field of view could allow for the visualization of all surgical fields, and automated tracking and iOCT autofocusing guarantee the continued centration of the image.

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Section: Intraoperative Oct: Technology and Characteristicsmentioning

confidence: 99%

Intraoperative OCT for Lamellar Corneal Surgery: A User Guide

Moramarco

Geronimo

Airaldi

et al. 2023

JCM

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Preoperative Evaluation of White Cataracts with the Pentacam

Toprak,

Alkan,

Bayrak

2024

Photodiagnosis and Photodynamic Therapy

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Intraoperative OCT (iOCT) Guidance for Determining Depth of Lens Grooving and Remaining Lens Thickness From the Posterior Capsule During Phacoemulsification in Cataract Surgery

Reinstein,

Gupta,

Patel

et al. 2023

Journal of Refractive Surgery Case Reports

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Purpose: To explore the utility of intraoperative optical coherence tomography (iOCT) in the determination of phacoemulsification groove depth and remaining lens thickness from the posterior capsule before lens cracking. Methods: In this retrospective analysis of 22 eyes, a remaining lens thickness (RLT) of less than 1.5 mm was defined as a suitable remainder to be achieved before initiating lens cracking. Phacoemulsification of the primary groove was carried out to a depth judged to be adequate by assessment of red reflex. An iOCT image was obtained; if the RLT was greater than 1.5 mm, further grooving was performed and a second iOCT measurement was obtained. Once the RLT was 1.5 mm or less, the surgeon proceeded with nucleus cracking. Results: The RLT was less than 1.5 mm in 90.9% of eyes (20/22). In 2 eyes (9.1%), the RLT was greater than 1.5 mm (cataract grade 2 and 5), which prompted further sculpting to deepen the groove. The final RLT was 0.99 and 0.90 mm in these 2 eyes, followed by lens cracking. Conclusions: Quantitative iOCT measurement enabled objective intraocular visualization of cataract groove depth prior to splitting the nucleus. Groove depth judgment using the red reflex resulted in an inadequate depth of grooving and a RLT of greater than 1.5 mm in 9% of eyes, even for an experienced surgeon. Greater difficulty was found in one dense cataract. The iOCT measurement may have helped dictate the need for further grooving before initiating lens cracking, thus minimizing the risk of a difficult or failed lens cracking. Objective confirmation of groove depth will be particularly useful for novice surgeons as they gain experience with the red reflex assessment and could be a helpful adjunct to phacoemulsification training. [ Journal of Refractive Surgery Case Reports. 2023;3(3):e28–e32.

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Intraoperative Anterior Segment Optical Coherence Tomography in the Management of Cataract Surgery: State of the Art

Cited by 4 publications

References 40 publications

Intraoperative OCT for Lamellar Corneal Surgery: A User Guide

Intraoperative OCT for Lamellar Corneal Surgery: A User Guide

Preoperative Evaluation of White Cataracts with the Pentacam

Intraoperative OCT (iOCT) Guidance for Determining Depth of Lens Grooving and Remaining Lens Thickness From the Posterior Capsule During Phacoemulsification in Cataract Surgery

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