iOCT technology is integrated into the surgical microscope and provides high-resolution cross-sectional images of ocular tissues, even transparent structures, during surgery. This allows for immediate identification of anatomical landmarks, accurate assessment of tissue planes and detection of any unexpected tissue changes during the procedure. With iOCT, surgeons can assess the adequacy of the surgical outcome, identify complications and modify surgical plans as necessary.
Reflecting the value of this technology, the ZEISS ophthalmic microscope portfolio offers intraoperative OCT solutions with two of its flagship microscope solutions, the ARTEVO 800 and the LUMERA 700 Rescan.
Imaging requirements across multiple pathologies have seen ZEISS build a range of features into its iOCT equipment. For example, the automatic XY tracker maintains the selected intraoperative OCT scan location and compensates for movements of the eye or the microscope. In addition, the operating surgeon is able to quickly change between high-resolution OCT scans (2.9mm scan depth in tissue) and large overview images (5.8mm scan depth in tissue) to visualise and assess graft orientation.
For those wanting to take advantage of the latest in digital technology, the ZEISS ARTEVO 800 offers the integration of intraoperative OCT and heads-up 3D display in one platform. The stereoscopic 3D image and accompanying data can all be viewed on a 55” 4K monitor that can be positioned anywhere in the operating room. This positions the ARTEVO 800 as an excellent ophthalmic microscope for teaching, with students able to experience the enhanced visualisation of DigitalOptics for natural colours, outstanding depth of field and high resolution, while the ARTEVO 800’s AdVision technology sees real-time data overlaid onto the active image without blocking the surgeon’s view of the eye.
iOCT technology can be seen to be having an impact across a range of anterior and posterior segment surgeries. In the corneal space, high-resolution iOCT images enable surgeons to evaluate the thickness and integrity of corneal grafts during transplantation, ensuring an optimal fit and reducing the risk of graft failure. The treatment of retinal diseases can also be aided by using iOCT. During surgery for macular diseases, such as macular hole or epiretinal membrane, iOCT enables the surgeon to precisely locate and manipulate the tissue, minimising the risk of complications and improving the surgical outcome.
iOCT has also become a vital element in many of the ground-breaking new gene therapy trials currently underway, ensuring the injection can be guided into the correct plane in the sub-retinal space, avoiding what would otherwise be a costly misplacement.
New Zealand looks set to be at the forefront in driving adoption of this technology as more New Zealand surgeons are gaining experience of improved surgical outcomes and increased efficiencies in the OR, using this latest technology.
