1034: Playlist: IntraOp OCT Scan

The intra-operative OCT scan is a rarity in ophthalmic operating rooms because of its cost which can add $60,000 to $100,000 to the cost of the surgical microscope. Our facility was fortunate to purchase a new surgical microscope two years ago with the added intra-operative OCT scanner. This allows us to get real-time, high resolution images during the surgery and we have found it particularly useful for looking at phaco incisions as well as lamellar corneal transplants. We have also used it for unusual cases such as this baby with congenital leukocoria. Our vitreo-retinal colleagues have also found the OCT useful in highlighting macular disease such as epi-retinal membranes. The OCT scan is also helpful for teaching the nuances of phaco incisions to our resident surgeons in training. The ability to see the incision architecture in such great detail is useful to hone our techniques to produce exactly the structure we desire.

Our first video is a good review of phaco incisions and analysis with the OCT. A great surgery begins with a great incision, and this video will show you how to achieve that.
What is the difference between a good phaco incision and a bad one? This video compares them and when we examine the wound architecture using the OCT scanner, the difference is clear.
A detachment of Descemet’s membrane can happen during cataract surgery using corneal incisions. This video shows the OCT analysis of the detachment and then teaches the best method to prevent worsening. It also shows how to reposition Descemet’s membrane and tamponade it in place.
Our last video shows the usefulness of the OCT scanner for lamellar corneal surgery. This case of combined phaco and DMEK poses a challenge with the graft is noted to be upside down. We carefully reposition it and then confirm success with the OCT scan.

1 Comment

  1. Looking to real time anterior segment oct including lens: this will be really precious in badvisualization situations

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