gms | German Medical Science

Purpose: To evaluate intraoperative diagnosis and assistence of microscope-mounted OCT-camera.

Patients and Methods: With the new developed OCT-Camera (MOELLER-WEDEL, Wedel, Germany in cooperation with OPTOMEDICAL TECHNOLOGIES, Luebeck, Germany), which was mounted on a surgical microscope (Hi-R 900, MOELLER-WEDEL) and equipped with microscope external display (MEDIS, MOELLER-WEDEL) 42 patients where evaluated during their routine posterior segment surgery. For posterior segment viewing a non-contact 90D lens (EIBOS, MOELLER-WEDEL) and contact vitrectomy flat lens (DORC; Zuidland, Netherlands) was used. The OCT-Camera consisted of a central wavelength of 840 nm, with a measuring depth of 5.2 mm and a measuring with dependant on the zoom of the microscope with a minimum of 5 mm at maximal zoom. Acquisition time was 10,000 A-scans/s. Image stacks, en-face OCT and 2D-real time imaging with additional volume scans of the procedures were recorded.

Results: With inraoperative OCT (iOCT) visualisation of posterior segment in spectral domain quality was feasible. Retinal membranes were analyzed in real-time and reconstructed in 3D and 2D over time. Pathologies such as epiretinal membranes, macular holes and vitreomacular tractions could be visualized in high-resolution prior and during surgical removal. Surgical instruments could be localized during manipulation according to the posterior extinction and backscattering of the OCT-laser.

Conclusion: iOCT with OCT-Camera enables high-resolution imaging of posterior segment procedures. It offers of delicate structures and tissue and offers intraopeartive control of the intended simplifies localization of instruments in relation to ocular structures and enables a direct intraoperative control of the intended therapy. iOCT has the potential to become a new technological intraoperative tool in ocular surgery.

Supported by the Medical Faculty Technology Transfer of the University of Luebeck.