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Case Reports
. 2015 Oct;46(9):964-6.
doi: 10.3928/23258160-20151008-10.

Intraoperative OCT-Assisted Subretinal Perfluorocarbon Liquid Removal in the DISCOVER Study

Adiel G Smith, Brian M Cost, Justis P Ehlers
Case Reports

Intraoperative OCT-Assisted Subretinal Perfluorocarbon Liquid Removal in the DISCOVER Study

Adiel G Smith et al. Ophthalmic Surg Lasers Imaging Retina. 2015 Oct.

Abstract

Background and objective: To assess the role for intraoperative optical coherence tomography (iOCT) during subretinal perfluoro-n-octane (PFO) removal and evaluate it as an assistive technique during surgical maneuvers.

Materials and methods: DISCOVER is a prospective study examining microscope-integrated iOCT systems in ophthalmic surgery. The authors report a technique utilizing iOCT guidance and feedback for surgical removal of chronic subretinal PFO.

Results: In this technique, real-time iOCT feedback successfully guided surgical maneuvers to facilitate removal of PFO. Due to the chronicity of the PFO, it was loculated and resistant to multiple maneuvers. Utilizing real-time feedback, additional maneuvers were attempted with feedback to the surgeon regarding the success of removal. Postoperatively, visual acuity improved with anatomic normalization.

Conclusion: Microscope-integrated iOCT with real-time feedback provided important information to the surgeon that helped facilitate subretinal PFO removal and guided surgical maneuvers.

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Figures

Figure 1
Figure 1. Intraoperative optical coherence tomography (OCT) for Subretinal perfluoro-n-octane removal
A – Macular photo demonstrating chronic retained subfoveal perfluoro-n-octane; B – Preoperative OCT visualization of subretinal perfluoro-n-octane; C – En face view (left) with corresponding intraoperative OCT 5-line raster (right) scan over macula depicting subretinal fluid present at beginning of case; D – Intraoperative en face view of subretinal bleb induction with 41G cannula (left) and iOCT 1-line raster scan (right) demonstrating subretinal bleb approaching subretinal perfluoro-n-octane; E – Intraoperative en face view of inferior PVR (left) with iOCT horizontal and vertical scan (right) demonstrating detached retina, PVR, and triescence staining; F – OCT at POM3 shows absence of perfluoro-n-octane, IS/OS junction abnormalities and trace cystoid edema.
See this image and copyright information in PMC

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