gms | German Medical Science

Purpose: Navigated surgery with augmented reality is already in routine use in other disciplines like neurosurgery. In ophthalmology early approaches incorporates anterior chamber parameters like augmented capsulorhexis boarders and toric axis projection. In future several other applications could active navigate the surgeon providing online eyetracked information. In this presentation a new retinal augmented navigation application is evaluated. The preoperative en face OCT analysis tool identifies elevated epiretinal membrane areas. These areas can be visualized intraoperative for peeling navigation. Purpose of the study is to assess the value of the area of the epiretinal membrane (ERM), which is not in contact with the retinal structure, as an intraoperative projection application and a prognostic factor for ERM surgery outcome.

Methods: Retrospective consecutive study including 80 eyes of 73 patients with the diagnosis of ERM. All eyes underwent pars plana vitrectomy (PPV) and ERM peeling assisted by a coloring agent by an experienced surgeon. Corrected distance visual acuity (CDVA) and CFT were evaluated preoperatively and at 6 months postoperatively. Furthermore, the ERM portion which was elevated was detected in the OCT image and processed digitally to obtain its area.

Results: LogMAR CDVA improved significantly with surgery (p<0.01). CFT decreased significantly with surgery (p<0.01). A statistically significant correlation was found between the change in LogMAR CDVA and preoperative CFT (r=–0.60, p <0.01), the preoperative elevated area of ERM and the change in LogMAR CDVA (r=–0.73, p <0,05).

Conclusions: This new enface OCT report could be used for safer membrane peeling and for prognostic evaluation of preoperative ERM. A better visual outcome is expected after PPV and membrane peeling in ERM eyes with preoperative high levels of elevated gliosis and CFT.

Financial disclosure: No