Outcomes of Intraoperative OCT–Assisted Epiretinal Membrane Surgery from the PIONEER Study

Ehlers, Justis P.; Khan, Mehnaz; Petkovsek, Daniel; Stiegel, Laura; Singh, Rishi P.; Reese, Jamie; Srivastava, Sunil K.

doi:10.1016/j.oret.2017.05.006

Cited by 33 publications

(19 citation statements)

References 30 publications

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“…Recently, microarchitectural changes after peeling, diagnosed with iOCT imaging after peeling compared to iOCT images before peeling, have been reported. Distances between the ellipsoid zone and retinal pigment epithelium, as well as between the cone outer segment tips/ interdigitation zone and retinal pigment epithelium, were significantly increased after peeling [13]. These changes indicate that traction-induced changes in retinal tissue occur during membrane peeling, even in cases without subfoveal/extrafoveal hyporeflective zones.…”

Section: Discussionmentioning

confidence: 83%

Effect of Subfoveal and Extrafoveal Hyporeflective Zones due to Iatrogenic Traction during Membrane Peeling for Epiretinal Membranes on Postoperative Outcomes

et al. 2019

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Purpose: The aim of our study using an intraoperative optical coherence tomography (iOCT) device was to assess the rate of neurosensory elevation with resulting subfoveal and extrafoveal hyporeflective zones during membrane peeling and to evaluate a possible influence on postoperative outcomes. Procedures: This study included patients scheduled for pars plana vitrectomy with membrane peeling due to idiopathic epiretinal membrane. All patients underwent 23-G pars plana vitrectomy with iOCT-guided membrane peeling and were scheduled for follow-up examinations at 1 day, 5 days, and 3 months after surgery. Results: Among the 171 patients included, subfoveal and extrafoveal hyporeflective zones could be detected in 12 patients (7%). Follow-up at 3 months after surgery was available for 149 patients with a median improvement in best corrected visual acuity of +2 lines (IQR: +1 to +4 lines). There were no significant differences in outcomes between patients with and those without subfoveal/extrafoveal hyporeflective zones concerning visual acuity, macular thickness, occurrence of intraretinal cystoid changes, and postoperative hyporeflective zones. Conclusions: No significant differences in postoperative outcomes were observed between patients with and those without subfoveal/extrafoveal hyporeflective zones.

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Section: Discussionmentioning

confidence: 83%

Effect of Subfoveal and Extrafoveal Hyporeflective Zones due to Iatrogenic Traction during Membrane Peeling for Epiretinal Membranes on Postoperative Outcomes

et al. 2019

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“…Moreover, some of the evidences also emphasize the reduced need for unintended surgical maneuvering with iOCT in the vicinity. 74 , 75 , 86 In an observation by Falkner-Radler et al, 87 in 40% of the cases dye was not necessary to peel the ERM, and, in around 95% of the cases iOCT ascertained its completeness with clear revelations on underlying traumatic changes if at all. 88 In another observation, 63% of the eyes were peeled off ERM without the use of dye, 89 hence, the 4D technology with volumetric information in real time can circumvent the need for dyes as well.…”

Section: Resultsmentioning

confidence: 98%

<p>Intraoperative Optical Coherence Tomography Guided Ocular Surgeries: Critical Analysis of Clinical Role and Future Perspectives</p>

Pujari¹,

Agarwal²,

Chawla³

et al. 2020

OPTH

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Intraoperative imaging of ocular tissues for diagnostic and therapeutic applications has gained immense admiration in recent years. The real time cross-sectional imaging, as well as three and four dimensional reconstruction abilities of intraoperative optical coherence tomography (iOCT), has enhanced our knowledge on many fronts in surgical maneuvers. In this review, we discuss the iOCT discovered constructive knowledge in the cornea, cataract, refractive, glaucoma, pediatric ocular, and various retinal conditions. The practical utility with decision modifying aspects along the specified ocular tissues and with respect to specific ocular entities have been narrated. Moreover, limitations and future directions have also been emphasized to make ophthalmic care more comprehensive in the future.

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“…For posterior segment surgery, iOCT appears to be particularly useful during membrane assessment, such as in PDR and ERM surgery. 25, 26 A recent prospective study utilizing microscope-integrated iOCT during membrane peeling procedures confirmed the ability of the technology to enhance visualization of the underlying membranes and subtle post-peel architecture changes. 15 An additional study recently reported membrane peeling with iOCT feedback was able to performed without the use of adjuvant dyes through the identification of membrane edges with the OCT system.…”

Section: Discussionmentioning

confidence: 78%

The DISCOVER Study 3-Year Results

et al. 2018

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Outcomes of Intraoperative OCT–Assisted Epiretinal Membrane Surgery from the PIONEER Study

Cited by 33 publications

References 30 publications

Effect of Subfoveal and Extrafoveal Hyporeflective Zones due to Iatrogenic Traction during Membrane Peeling for Epiretinal Membranes on Postoperative Outcomes

Effect of Subfoveal and Extrafoveal Hyporeflective Zones due to Iatrogenic Traction during Membrane Peeling for Epiretinal Membranes on Postoperative Outcomes

<p>Intraoperative Optical Coherence Tomography Guided Ocular Surgeries: Critical Analysis of Clinical Role and Future Perspectives</p>

The DISCOVER Study 3-Year Results

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