Evaluation of intraocular lens position during phacoemulsification using intraoperative spectral-domain optical coherence tomography

Lytvynchuk, Lyubomyr; Glittenberg, Carl; Falkner-Radler, Christiane I.; Neumaier-Ammerer, Beatrix; Smretschnig, Eva; Hagen, Stefan; Ansari-Shahrezaei, Siamak; Binder, Susanne

doi:10.1016/j.jcrs.2016.01.044

Cited by 26 publications

(23 citation statements)

References 17 publications

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“…В различных исследованиях, с использовани-ем количественного ОКТ-анализа, выявлена высокая частота отсутствия полного контакта задней капсулы с ИОЛ по окончании операции -99,02%, а в первый по-слеоперационный день -41,5%. Прослежена положи-тельная динамика в течение 1-2 месяцев, в ряде случаев (7,1-26,8%) обнаружено отсутствие адгезии ЗКХ к ИОЛ в более поздние сроки, оценено влияние данного состоя-ния на качество зрения, определены периоды формиро-вания капсульного перегиба через край оптической части ИОЛ, которые в различных исследованиях варьировали от 10 дней до 1 месяца и более [6,7,9,10]. Сравнительные исследования выявили более слабую динамику трансфор-мации пространства капсульный мешок хрусталика-ИОЛ при высокой миопии, а также отличия в формировании взаимоотношений ЗКХ-ИОЛ при имплантации различ-ных моделей линз [6,[8][9][10][11]19].…”

Section: Discussionunclassified

“…Современные методы визуализации в офтальмологии (оптическая когерентная томография, шеймпфлюг-изо-бражение) позволяют прецизионно исследовать данную область [3][4][5][6]. Послеоперационная трансформация КМХ является объектом многочисленных ОКТ-исследований, оценивающих темпы, особенности и обстоятельства данного процесса [7][8][9][10][11].…”

Section: актуальностьunclassified

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Anatomical and Topographical Relations between the Posterior Lens Capsule and the Intraocular Lens in Pseudoexfoliation Syndrome

Егорова¹

2018

Ophthalmology in Russia

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Purpose— to study the relations between the posterior capsule (PC) and intraocular lens (IOL) after cataract surgery in pseudoexfoliation syndrome (PEX).Patients and methods. We examined 46 eyes of 37 patients with PEX who underwent a standard and uncomplicated phacoemulsification. The age of patients was 60–94 years. Postoperative period ranged from 1 day to 10 years. An optical coherence tomography (OCT) (RTVue XR Avanti, “Optovue”) was used to image the IOL-PC space in early and late postoperative period.Results. In the first days full contact PC-IOL was not observed in any case. The maximum of space PC-IOL was noted on the first day postoperatively. Posterior capsule had a wavy or folded profile on the scans. In the next two weeks we observed a decrease of the distances between posterior capsule and IOL. After 1 month we noted the formation of capsular bend around optic edge, the full adhesion of posterior capsule to IOL was not detected. In the late postoperative period the fibroplastic and proliferative capsular changes with secondary discontact PC-IOL was noted. Primary inadhesion of a posterior capsule to IOL was recorded in half of the cases.и. High resolution OCT was suitable for quantitative analysis of IOL-PC space. Involution changes in structures of anterior segment in the eyes with PEX had a role in closure of the IOL-PC space. Complete adhesion of posterior capsule to IOL was not observed in the majority of eyes with PEX.

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Section: Discussionunclassified

Section: актуальностьunclassified

Anatomical and Topographical Relations between the Posterior Lens Capsule and the Intraocular Lens in Pseudoexfoliation Syndrome

Егорова¹

2018

Ophthalmology in Russia

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“…[16] IOL position and stability is crucial in cases undergoing penetrating keratoplasty or endothelial keratoplasty, where iOCT may help in decision-making regarding exchange or explant of IOL.…”

Section: Cataract Surgerymentioning

confidence: 99%

Intraoperative optical coherence tomography in anterior segment surgeries

Titiyal

Kaur

Falera

2017

Indian J Ophthalmol

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Intraoperative optical coherence tomography (iOCT) is a noninvasive imaging modality that provides a real-time dynamic feedback of the various surgical steps. Comprehensive literature search was performed in MEDLINE using “intraoperative optical coherence tomography” and “iOCT” as keywords. The use of iOCT as an aid to decision-making has been successfully reported in cases undergoing keratoplasty, implantable Collamer lens (ICL) implantation as well as cataract surgery. iOCT helps to assess the graft-host relationship in penetrating keratoplasty. It helps confirm the presence of a big bubble, detect subclinical big bubbles and guide layer by layer stromal dissection in cases of deep anterior lamellar keratoplasty. It acts as a guide during crucial surgical steps in endothelial keratoplasty, right from scoring of the Descemet membrane to ensuring graft apposition at the end of surgery. The morphological features of the corneal incision in phacoemulsification may be assessed. iOCT is a useful tool in assessing the status of the posterior capsule and may help identify preexisting posterior capsular defects during cataract surgery in various clinical scenarios such as posterior polar cataract, traumatic cataract, and vitrectomized eyes. It allows on-table assessment of the ICL vault and potentially facilitates exchange of ICL in the same sitting in extremes of vault. Ocular surface disorders such as ocular surface squamous neoplasia, pterygium, and dermoid may find an application for iOCT, wherein an iOCT-guided stromal dissection will ensure adequate depth of dissection. Further technological advancements may allow for automatic centration and tracking and address the present limitation of instrument-induced shadowing.

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“…Außerdem zeigte sich, dass in 57,3 % der Fälle ein nur partieller Kontakt von IOL und Hinterkapsel vorgelegen hatte. Basierend auf diesen iOCT-Daten regen die Autoren neue Intraokularlinsendesigns an, die einen besseren Kontakt von Intraokularlinse und Hinterkapsel ermöglichen und so zu einer besseren Nachstarprävention beitragen können [45]. In der refraktiven Linsenchirurgie könnte iOCT am aphaken Auge eingesetzt werden, um durch eine intraoperativ erneute Bestimmung von Vorderkammertiefe und neu berechneter Linsenposition die Zielrefraktion genauer zu erreichen [46].…”

Section: Kataraktchirurgieunclassified

Intraoperative optische Kohärenztomografie – eine aktuelle Übersicht klinischer Studien zur Anwendung im Vorder- und Hinterabschnitt

Augustin

2017

Klin Monatsbl Augenheilkd

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Intraoperative optical coherence tomography (iOCT) represents another milestone in ocular imaging technologies. Now, for the first time, high resolution OCT images are available not only pre- or postoperatively, but also intraoperatively. In recent years, there have been significant advances in iOCT technology - from hand-held probes and mounted systems towards iOCT systems which are fully integrated into the surgical microscope and which provide seamless integration into the workflow. These systems offer high-resolution, intraoperative OCT scans in real-time and provide additional information on microstructures of the retina or the cornea. These findings may even lead to a modification of surgical strategies. Like any other new technology, iOCT technology still has some limitations, such as shadowing from instruments and the lack of eye tracking systems. Therefore, the current state of iOCT technology still requires some skill to track surgical maneuvers in real time. Further research and development will help to solve these limitations in the future. However, even if not required for all surgical procedures, iOCT imaging can already improve safety and control in many surgical procedures on the anterior and posterior segments. This has already been shown in several studies and case series. Particularly in the surgery of vitreomacular traction, peeling of epiretinal membranes (ERM peeling) and macular hole surgery, iOCT offers significant added value. It improves the visualisation of transparent structures and helps to avoid the usage of dyes. In addition the success of the surgical maneuvers can be investigated intraoperatively. In lamellar keratoplasty and glaucoma surgery too, iOCT improves precision and safety. Moreover, iOCT technology may help to achieve further insight into ocular pathologies and a better understanding of the impact of surgical maneuvers on visual rehabilitation. Further prospective studies are however required to evaluate the usefulness of iOCT in various surgical procedures on both, the anterior and posterior segments.

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Evaluation of intraocular lens position during phacoemulsification using intraoperative spectral-domain optical coherence tomography

Abstract: Drs. Binder and Glittenberg are consultants to Carl Zeiss Meditech AG. None of the other authors has a financial or proprietary interest in any material or method mentioned.

Cited by 26 publications

References 17 publications

Anatomical and Topographical Relations between the Posterior Lens Capsule and the Intraocular Lens in Pseudoexfoliation Syndrome

Anatomical and Topographical Relations between the Posterior Lens Capsule and the Intraocular Lens in Pseudoexfoliation Syndrome

Intraoperative optical coherence tomography in anterior segment surgeries

Intraoperative optische Kohärenztomografie – eine aktuelle Übersicht klinischer Studien zur Anwendung im Vorder- und Hinterabschnitt

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