Falkner-Radler Christiane I, Glittenberg Carl, Gabriel Max, Binder Susanne
Ludwig Boltzmann Institute for Retinology and Biomicroscopic Lasersurgery, Department of Ophthalmology, Rudolf Foundation Clinic, Teaching Hospital of the Medical University, Vienna, Austria.
Retina. 2015 Oct;35(10):2100-6. doi: 10.1097/IAE.0000000000000596.
To evaluate microscope-integrated intrasurgical spectral domain optical coherence tomography during macular surgery in a prospective monocenter study.
Before pars plana vitrectomy and before, during, and after membrane peeling, 512 × 128 macular cube scans were performed using a Carl Zeiss Meditec Cirrus high-definition OCT system adapted to the optical pathway of a Zeiss OPMI VISU 200 surgical microscope and compared with retinal staining.
The study included 51 patients with epiretinal membranes, with 8 of those having additional lamellar macular holes, 11 patients with vitreomacular traction, and 8 patients with full-thickness macular holes. Intraoperative spectral domain optical coherence tomography allowed performing membrane peeling without using retinal dyes in 40% of cases (28 of 70 patients). No residual membranes were found in 94.3% of patients (66 of 70 patients) in intrasurgical spectral domain optical coherence tomography and subsequent (re)staining. In patients with vitreomacular traction, intrasurgical spectral domain optical coherence tomography scans facilitated decisions on the need for an intraocular tamponade after membrane peeling.
Intraoperative spectral domain optical coherence tomography was comparable with retinal dyes in confirming success after membrane peeling. However, the visualization of flat membranes was better after staining.
在一项前瞻性单中心研究中评估黄斑手术期间显微镜集成式术中光谱域光学相干断层扫描技术。
在进行玻璃体切割术前以及膜剥离术的术前、术中和术后，使用适配于蔡司OPMI VISU 200手术显微镜光路的卡尔蔡司Meditec Cirrus高清光学相干断层扫描（OCT）系统进行512×128黄斑立方体扫描，并与视网膜染色结果进行比较。
该研究纳入了51例视网膜前膜患者，其中8例伴有额外的板层黄斑裂孔，11例患有玻璃体黄斑牵引，8例患有全层黄斑裂孔。术中光谱域光学相干断层扫描使得40%的病例（70例患者中的28例）在不使用视网膜染料的情况下进行膜剥离。在术中光谱域光学相干断层扫描及随后的（再）染色中，94.3%的患者（70例患者中的66例）未发现残留膜。在患有玻璃体黄斑牵引的患者中，术中光谱域光学相干断层扫描有助于确定膜剥离后是否需要眼内填充。
术中光谱域光学相干断层扫描在确认膜剥离成功方面与视网膜染料相当。然而，染色后扁平膜的可视化效果更好。
