Session Title: Imaging II
Session Date/Time: Friday 18/09/2015 | 16:30-18:00
Paper Time: 17:34
First Author: : C.Riemann UNITED STATES
Co Author(s): : O. Toygar
PURPOSE:We report microanatomical relationships during surgical repair of macula involving retinal detachment with pars plana vitrectomy (PPV) and perfluoro-n-octane (PFO) with a microscope integrated intraoperative optical coherence tomography (iOCT) device.
The study was performed in Cincinnati Eye Institute (Cincinnati, OH).
This prospective consecutive case series included nine eyes of nine patients with macula involving retinal detachment. All patients underwent PPV, PFO injection, air fluid exchange with meticulous drying of all retinal breaks, Endolaser, and intraocular gas tamponade. The macula was imaged with the Haag Streit iOCT (Haag Streit Surgical, Wedel, Germany). Images were obtained prior to PFO injection, after PFO injection, and after air fluid exchange in all eyes.
iOCT imaging was ergonomically easy to obtain in all eyes. Image quality was excellent. iOCT clearly demonstrated; submacular fluid (SMF) at the beginning of the surgery, macular flattening under PFO, and increased occult SMF following air fluid exchange in all eyes.
Microscope integrated iOCT is a versatile and powerful imaging modality that holds a great deal of promise in the future. Its confirmation of persistent occult SMF in this small series of macular involving retinal detachment repair with PFO, suggests a pathophysiological mechanism which may play a role in postoperative metamorphopsia, macular folds and retinal slippage and presents a very convincing rationale for the strict face down positioning for at least 24 hours after retinal detachment repair in these patients.