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BENEFIT OF INTRAOPERATIVE OPTICAL COHERENCE TOMOGRAPHY FOR VITREOMACULAR SURGERY IN HIGHLY MYOPIC EYES

Bruyère, Elsa, MD; Philippakis, Elise, MD; Dupas, Bénédicte, MD; Nguyen-Kim, Pauline, MD; Tadayoni, Ramin, MD, PhD; Couturier, Aude, MD

doi: 10.1097/IAE.0000000000001827
Original Study: PDF Only

Purpose: To report the feasibility and information provided by intraoperative optical coherence tomography (iOCT) during vitreomacular surgery in highly myopic eyes.

Methods: Retrospective observational case series on consecutive highly myopic eyes that underwent vitreomacular surgery with iOCT for epiretinal membrane (ERM), macular hole, and myopic foveoschisis. The main outcome was the qualitative and quantitative assessment of retinal changes: detection of persistent epiretinal structures, new openings, central macular thickness, and macular hole diameters after each step of the surgical procedure. Quantitative measurements (in pixels) were manually obtained on iOCT video screen captures.

Results: Twenty-two eyes were included: six ERMs, 10 macular holes, and 6 with myopic foveoschisis. An unsuspected postpeeling macular opening was detected by iOCT in 2/22 eyes. Intraoperative optical coherence tomography also allowed for detecting the presence of residual fragments of the vitreous cortex in 6/12 eyes after surgically induced posterior vitreous detachment. Intraoperative optical coherence tomography detected residual fragments of the internal limiting membrane in 5/21 eyes after internal limiting membrane peeling, and residual fragments of ERM in 3/15 eyes with ERM. Quantitative analysis did not find any significant change in central macular thickness and macular hole diameters before and after ERM and internal limiting membrane peeling.

Conclusion: In highly myopic eyes, iOCT could help assess undetected macular openings and otherwise posterior vitreous status and epiretinal structure peeling.

In a series of 22 highly myopic eyes, intraoperative optical coherence tomography was able to detect the persistent vitreous cortex, residual epiretinal structures, and otherwise undetected macular openings. In the remaining cases, the peeling-induced acute traction did not significantly alter macular morphology.

Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7—Sorbonne Paris Cité, Paris, France.

Reprint requests: Aude Couturier, MD, Department of Ophthalmology, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris, France; e-mail: aude.couturier@aphp.fr

R. Tadayoni is consultant (C), has received Lecture Fees (L) and Grant support (S) from Zeiss. The remaining authors have no any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.