The DISCOVER Study 3-Year Results

Abstract

The DISCOVER iOCT study demonstrated both generalized feasibility and usefulness based on the surgeon-reported impact on surgical decision making. This large-scale study confirmed similar findings from other studies on the potential value and impact of iOCT on ophthalmic surgery.

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

“…Considering DALK, successful big-bubble formation depends on the depth reached by the cannula tip from the internal corneal surface. In the DISCOVER study, MI-OCT confirmed the big-bubble formation already noted clinically in three of ten cases; in two of ten cases, it guided additional manoeuvres as the bubble was incomplete, and in three of ten cases, it helped the surgeon in manual stromal dissection by confirming the dissection depth [ 13 ]. Specifically, the average depth in successful cases is lower than that in failed ones, which have an increased risk of conversion to PK (90.4 μm versus 136.7 μm, respectively), requiring a manual deep lamellar dissection [ 99 ].…”

“…Thirty-one articles were excluded: 19 were not written in English, 9 were review papers, and 3 were ex vivo studies. After full-text evaluation, 82 studies discussing the use of MI-OCT in ophthalmology were included [ 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , ...…”

“…In 43.4% of cases (106 patients), MI-OCT modified surgical decision-making; in particular, considering graft position or persistence of fluid. In anterior segment procedures, real-time feedback was the favoured imaging modality and the preferred review strategy was external screen display, compared to microscope oculars [ 13 ].…”

“…These instruments have been proven to be feasible in the operating theatre, as well as safe and useful in decision-making processes [ 12 , 13 ].…”

Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy Using a Novel Digital Microscope with Integrated Intraoperative Optical Coherence Tomography

“…Optical coherence tomography (OCT) is an indispensable diagnostic tool for managing numerous ophthalmic diseases. Observation of the ocular microarchitectural structures using microscope-integrated intraoperative OCT (iOCT) was initially conducted using an external portable OCT system mounted on a microscope [9] and, more recently, using an OCT system integrated into surgical microscopes [10]. iOCT was adopted initially in vitreoretinal surgery to assess macular holes and epiretinal membranes [10], in corneal surgery to visualize the donor cornea during endothelial keratoplasty [11], and in cataract surgery to evaluate the intraocular lens position [12].…”