Macular Hole Formation Identified With Intraoperative Oct During Vitrectomy for Vitreomacular Traction Syndrome

Sawaguchi, S.; Maruko, Ichiro; Mikami, Yuriko; Hasegawa, Taiji; Koizumi, Hideki; Iida, Tomohiro

doi:10.1097/icb.0000000000000377

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…The evidence of the DISCOVER study on macular hole formation during surgery for vitreomacular interface syndrome has been confirmed in other reports, modifying surgical approach and tamponade choice [ 70 , 71 ].…”

Section: Resultsmentioning

confidence: 59%

“…Thirty-one articles were excluded: 19 were not written in English, 9 were review papers, and 3 were ex vivo studies. After full-text evaluation, 82 studies discussing the use of MI-OCT in ophthalmology were included [ 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , ...…”

Section: Resultsmentioning

confidence: 99%

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What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

Posarelli

Sartini

Casini

et al. 2020

JCM

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Background: Optical coherence tomography (OCT) has recently been introduced in the operating theatre. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Method: A total of 314 studies were identified, following a literature search adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. After full-text evaluation, 81 studies discussing MI-OCT applications in ophthalmology were included. Results: At present, three microscope-integrated optical coherence tomography systems are commercially available. MI-OCT can help anterior and posterior segment surgeons in the decision-making process, providing direct visualization of anatomic planes before and after surgical manoeuvres, assisting in complex cases, and detecting or confirming intraoperative complications. Applications range from corneal transplant to macular surgery, including cataract surgery, glaucoma surgery, paediatric examination, proliferative diabetic retinopathy surgery, and retinal detachment surgery. Conclusion: The use of MI-OCT in ophthalmic surgery is becoming increasingly prevalent and has been applied in almost all procedures. However, there are still limitations to be overcome and the technology involved remains difficult to access and use.

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Section: Resultsmentioning

confidence: 59%

Section: Resultsmentioning

confidence: 99%

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

Posarelli

Sartini

Casini

et al. 2020

JCM

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“…A recent study by Sawaguchi et al . 9 described a fascinating case of an MH developing intraoperatively during vitrectomy for VMTS, imaged on intraoperative OCT. As a result, the authors performed ILM peeling and pneumatic tamponade. Additionally, previous studies consistently show a trend of MH formation after repair of RD involving the macula, but the underlying cause is yet to be fully understood 11,18 .…”

Section: Discussionmentioning

confidence: 99%

“…Current literature describes cases of secondary MH after surgical repair of retinal detachments (RD) 8 , epiretinal membranes (ERM) 2 , vitreomacular traction syndrome (VMTS) 9 , and myopic foveoschisis 10 . These studies also document a wide combination of adjuvant techniques used during the initial vitrectomy, such as ILM peeling, scleral buckling, and pneumatic tamponade 11 .…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics, risk factors, and surgical outcomes of secondary macular hole after vitrectomy

Kang

Han

Choi

et al. 2019

Sci Rep

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Secondary macular hole(MH) formation after vitrectomy is rare and its risk factors and pathogenesis are not clearly understood. This retrospective study was conducted to identify the risk factors of this complication and assess outcomes at 2 tertiary centres. The primary outcomes were the clinical characteristics associated with development of secondary MH, which included the primary diagnosis for initial vitrectomy, features on optical coherence tomography, and adjuvant surgical techniques used during the initial surgery. Secondary outcomes included the change in best-corrected visual acuity(BCVA), clinical factors associated with the need for re-operations for MH closure and prognostic factors for the visual outcomes. Thirty-eight eyes out of 6,354 cases (incidence 0.60%) developed secondary MH after undergoing vitrectomy for various vitreoretinal disorders over an 11-year period, most frequently after initial surgery for retinal detachment(RD) (9 eyes) and secondary epiretinal membrane (6 eyes). The mean age was 57.1 years (range: 17.8–76.7), and the mean follow-up was 51.1 months (range: 6.8 to 137.6). Prior to secondary MH formation, development of ERM was the most common OCT feature (19 eyes, 50%), and no cases of cystoid macular oedema (CME) were observed. A greater proportion of eyes with secondary MH had long axial lengths (32% ≥26 mm vs 5% of eyes ≤22 mm). MH closure surgery was performed in 36 eyes and closure was achieved in 34 (success rate 94%, final BCVA 20/86), with ≥3-line visual gain in 18 cases. BCVA at MH onset (OR = 0.056, P = 0.036), BCVA at post-MH surgery month 3 (OR = 52.671, P = 0.011), and axial length ≥28 mm (OR = 28.487, P = 0.030) were associated with ≥3-line visual loss; a history of macula-off RD (OR = 27.158, P = 0.025) was associated with the need for multiple surgeries for MH closure. In conclusion, secondary MH occurs rarely but most commonly after vitrectomy for RD. Patients with axial length ≥28 mm and poor BCVA at 3 months post-operation may have limited visual prognosis; those with a history of macula-off RD may require multiple surgeries for hole closure.

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“…Die Anwendung der iOCT während verschiedener Eingriffe des Hinterabschnitts wurde in zahlreichen klinischen Studien und vor allem Fallserien untersucht [7][8][9][10][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Grundsätzlich kann festgehalten werden, dass sich der iOCT-Einsatz immer dann als hilfreich erweist, wenn der Einblick in den Hinterabschnitt erschwert ist, wie z.…”

Section: Anwendungen Im Hinterabschnittunclassified

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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Macular Hole Formation Identified With Intraoperative Oct During Vitrectomy for Vitreomacular Traction Syndrome

Abstract: It is possible to change the surgical approach using the real-time intraoperative OCT because the development of macular hole can be visualized during vitrectomy for vitreomacular traction syndrome.

Cited by 4 publications

References 10 publications

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

Clinical characteristics, risk factors, and surgical outcomes of secondary macular hole after vitrectomy

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

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