How has intraoperative OCT improved outcomes in epiretinal membrane surgery?
Makaleler > Tam Makale · 2025
Yazarlar: Zeynep AKGÜN, Filiz Afrashi, Cumali DEĞİRMENCİ
Photodiagnosis and Photodynamic Therapy, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2025, cilt 53, ss 104586-104586
DOI: 10.1016/j.pdpdt.2025.104586
Özet
• iOCT has opened a new perspective, especially in posterior segment surgery. • BCVA increased statistically significantly in the iOCT group. • Mean decrease in CFT and EZD was similar between iOCT and control groups. • Foveal contour showed significant improvement in the iOCT group. To compare the functional and anatomical outcomes of patients who underwent intraoperative optical coherence tomography (iOCT)-guided or conventional epiretinal membrane (ERM) surgery and to assess the role of iOCT in ERM surgery. The medical records of patients who underwent pars plana vitrectomy (PPV) or a combined surgery (PPV + cataract extraction) for idiopathic ERM were reviewed retrospectively ( n = 62). The patients were divided into two groups: Group 1( n = 29) underwent iOCT guided surgery and Group 2 ( n = 31) underwent conventional surgery. Pre- and postoperative 12 th month best corrected visual acuity (BCVA), central foveal thickness (CFT), ellipsoid zone defect (EZD), and nature of foveal contour were compared. The mean age was 69.58 ± 5.69 (60–81) years in Group 1 and 73.33 ± 6.74 (56–83) years in Group 2 ( p = 0.022). There was no significant difference in the Female/Male ratio, lens status (phakic or pseudophakic), and type of surgery (PPV or PPV + cataract extraction) between the two groups ( p > 0.05 for all). The preoperative and postoperative mean BCVA was 0.30 ± 0.21 (0.005–0.7) and 0.47 ± 0.31 (0.016–1) ( p < 0.001) respectively in Group 1, and 0.21 ± 0.16 (0.001–0.7) and 0.30 ± 0.25 (0.008–1) ( p = 0.385), respectively in Group 2. The preoperative and postoperative mean CFT was 495.2 ± 128.7 (301–763) µm and 339.1 ± 97.6 (193–545) µm in Group 1 ( p < 0.001) and 555.1 ± 96.9 (362–807) µm and 400.1 ± 67.69 (246–637) µm in Group 2, respectively ( p < 0.001). The decrease in mean CFT was similar between the two groups ( p = 0.749). Although pre- and postoperative EZD were similar, the nature of the foveal contour was significantly improved in Group 1. Integrating OCT into the operating microscope provides perioperative visualization of the retinal layers, vitreous, and vitreomacular interface; moreover, it enables instrument-tissue interactions. ERM and secondary traction to the membrane can be easily visualized with iOCT. Although the use of iOCT did not lead to a statistically significant difference in anatomical results, it could improve functional outcomes.