Application of Intraoperative Optical Coherence Tomography Technology in Anterior Segment Surgery

Abstract

The use of optical coherence tomography (OCT) technology in anterior segment diseases allows for precise assessment of the changes following anterior segment surgery. Advances in microscope-integrated OCT systems have allowed the utilization of intraoperative OCT (iOCT) in anterior segment surgeries, i.e., cornea, cataract, and refractive surgery. iOCT has enabled real-time precise visualization of anterior segment tissues as well as interactions between surgical instruments and ocular tissue; thus, the device can facilitate surgical procedures and provide valuable information for decision-making during anterior segment surgeries. In this review, the authors will introduce studies regarding the development of iOCT technology and its application in various anterior segment surgeries. Multiple studies have shown the efficacy of the iOCT for intraoperative assistance and guidance, suggesting the potential of the device for optimizing the surgical outcomes after cornea, cataract, and refractive surgery.

Visualization of Cataract Surgery Steps With 4D Microscope-Integrated Swept-Source Optical Coherence Tomography in Ex Vivo Porcine Eyes

“…Optical coherence tomography (OCT) is a valuable tool for preoperative and postoperative examinations in cataract surgery, but it is rarely used intraoperatively, despite the availability of dedicated solutions. 1 , 2 Preoperative examinations include intraocular lens (IOL) power calculations that are commonly performed using optical biometry devices with an underlying technology similar to OCT. 3 In addition, preoperative OCT imaging of the macula allows the detection of abnormalities that may limit postoperative visual acuity gains. 4 Postoperative OCT imaging focuses on corneal wound 5 and IOL position monitoring, 6 as well as assessment for macular edema.…”

Clinical significance of signal shadowing during intraoperative optical coherence tomography-assisted vitreoretinal surgery

“…This concept, known as interferometry, functions comparatively to an ultrasound, but based on light waves instead 8 , 9 . These characteristics enable OCT to accurately visualize translucent objects 17 .…”

“…Due to these features, just like the pioneering time domain OCT, the currently used spectral domain and swept source OCTs rapidly became a central diagnostic tool in ophthalmology, redefining the assessment criteria for many ophthalmologic disorders 1 . While employed on both the anterior and posterior segments of the eye, OCT imaging is particularly useful to detect and monitor retinal pathologies 14 , 17 . Retinal anatomy, especially its layered structure has been extensively documented using OCT, providing a concrete visualization of cellular layers.…”

Intraoperative Optical Coherence Tomography for Ab Interno Trabecular Bypass Glaucoma Surgery

“…1 The earliest iOCT systems were lightweight, handheld portable OCTs. 2,3 However, these were time-consuming, lacked stability, and did not provide real-time intraoperative imaging feedback to the surgeon. 2 Subsequently, microscope-integrated iOCTs were developed.…”

“…2,3 However, these were time-consuming, lacked stability, and did not provide real-time intraoperative imaging feedback to the surgeon. 2 Subsequently, microscope-integrated iOCTs were developed. These provided improved stability, higher image quality, faster image acquisition, reduced surgical delay, and enhanced sterility.…”