ObjectiveTo evaluate the assistant effect of intraoperative OCT (iOCT) in vitreous retinal surgery for macular disease.MethodsA retrospective case study. A total of 71 patients (71 eyes) with macular disease who underwent vitrectomy in Eye Hospital of Wenzhou Medical University at Hangzhou from June 2015 to September 2016 were collected. There were 24 males (24 eyes) and 47 females (47 eyes), aged from 25 to 78 years, with the mean age of 63.35±10.01 years. Among 71 eyes, there were 26 eyes with idiopathic macular hole, 42 eyes with idiopathic epiretinal membrane, 3 eyes with vitreomacular traction syndrome. The examination of iOCT was performed on the patients during 23G minimally invasive vitreoretinal surgery combined with internal limiting membrane peeling. Use observational method to compare the difference between result of iOCT and observation under the microscope, record the change of treatment strategy.ResultsEight eyes (11.27%) iOCT results were different from the surgeon’s observation, which including 5 eyes (62.50%) with idiopathic macular hole, 2 eyes (25.00%) with idiopathic epiretinal membrane, 1 eye (12.50%) with vitreomacular traction syndrome. The treatment strategy was changed in 8 eyes (11.27%) based on iOCT result, which including 5 eyes (62.50%) with idiopathic macular hole, 2 eyes (25.00%) with idiopathic epiretinal membrane, 1 eye (12.50%) with vitreomacular traction syndrome.ConclusionsiOCT can help the surgeon find some subtle morphological changes which can hardly be seen by eyes. The surgeon can change and optimize the treatment strategy based on the result of iOCT.
ObjectiveTo observe the preliminary application of intraoperative optical coherence tomography (iOCT) in vitreous retinal surgery and the influencing factors of the imaging quality. MethodsA retrospective case study. A total of 132 subjects were chosen in June 2015 and April 2016 in our hospital. All the subjects were taken vitreous retinal surgery and iOCT scanning. The patients included 46 males and 86 females, with an average age of 61.7 years. 111 cases had macular diseases and 21 cases had vitreous hemorrhage. Cases are divided into high myopia and non-high myopia group according to ocular axial length (AL), 28 eyes in high myopia group (AL≥26 mm),104 eyes in non-high myopia (AL<26 mm).The scanning time, image quality and eye conditions were observed during the operation. The discordance between surgeon microscope visualization of the pathology and the findings of the iOCT and the postoperative adverse reactions were also observed. ResultsThe iOCT images were identified in 124 of 132 subjects, while were not identified in 8 eyes. For the macular area morphology change, iOCT tips and surgeon judgment rate was inconsistent in 22 eyes (16.7%). For the operation guidance value, change the operation rate of 12/132,accounted for 9.1%. The iOCT imaging quality of high myopia groups was lower than the non-high myopia groups (χ2=17.13, P=0.001). Corneal edema and operation time were considered as influencing factors on the quality of the imaging in the non-high myopia groups (r=3.75, 6.18; P=0.049, 0.013). There were no complications such as endophthalmitis. ConclusionsThe surgeon can observe morphological changes in the macular area through iOCT which is difficult to be observed by operating microscope and selected reasonable operation method during the surgery. High myopia, corneal edema and operation time affect the image quality.