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Article Abstract
Purpose: 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.
Methods: 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 month best corrected visual acuity (BCVA), central foveal thickness (CFT), ellipsoid zone defect (EZD), and nature of foveal contour were compared.
Results: 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.
Conclusion: 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.
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| http://dx.doi.org/10.1016/j.pdpdt.2025.104586 | DOI Listing |
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