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角膜手术中的术中光学相干断层扫描成像:文献综述与新应用建议

Intraoperative Optical Coherence Tomography Imaging in Corneal Surgery: A Literature Review and Proposal of Novel Applications.

作者信息

Eguchi Hiroshi, Hotta Fumika, Kusaka Shunji, Shimomura Yoshikazu

机构信息

Department of Ophthalmology, Kindai University, Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka 589-8511, Japan.

Department of Ophthalmology, Fuchu Eye Center, 1-10-17 Hiko-cho, Izumi, Osaka 594-0076, Japan.

出版信息

J Ophthalmol. 2020 Sep 11;2020:1497089. doi: 10.1155/2020/1497089. eCollection 2020.

Abstract

Intraoperative optical coherence tomography (OCT) is widely used in ophthalmic surgeries for cross-sectional imaging of ocular tissues. The greatest advantage of OCT is its adjunct diagnostic efficacy, which facilitates to decision-making during surgery. Since the development of microscopic-integrated OCT (MIOCT), it has been widely used mainly for vitreoretinal and anterior segment surgeries. In corneal transplantation, MIOCT allows surgeons to visualise structure underneath the turbid and distorted cornea, which are impossible to visualise with a usual microscope. Real-time visualisation of hard-to-see area reduces the operation time and leads to favorable surgical outcomes. The use of MIOCT is advantageous for a variety of corneal surgical procedures. Here, we have reviewed articles focusing on the utility of OCT  and MIOCT in penetrating keratoplasty, deep anterior lamellar keratoplasty, Descemet stripping automated endothelial keratoplasty, and Descemet membrane endothelial keratoplasty. The applications of MIOCT to corneal surgery in terms of surgical education for trainees, emergency surgery, and novel surgery are also discussed, with our cases performed using RESCAN 700.

摘要

术中光学相干断层扫描(OCT)在眼科手术中广泛用于眼部组织的横断面成像。OCT的最大优势在于其辅助诊断功效,有助于手术过程中的决策制定。自从显微集成OCT(MIOCT)问世以来,它主要广泛应用于玻璃体视网膜手术和眼前节手术。在角膜移植手术中,MIOCT使外科医生能够看清混浊和变形角膜下方的结构,而这是普通显微镜无法做到的。对难以看清区域的实时可视化减少了手术时间,并带来良好的手术效果。MIOCT的使用对多种角膜外科手术都有利。在此,我们回顾了聚焦于OCT和MIOCT在穿透性角膜移植术、深板层角膜移植术、后弹力层剥除自动内皮角膜移植术和后弹力层内皮角膜移植术中效用的文章。还讨论了MIOCT在角膜手术中在培训学员的手术教育、急诊手术和新型手术方面的应用,并介绍了我们使用RESCAN 700进行的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3826/7803131/88c33ca58c80/joph2020-1497089.001.jpg

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