ESCRS - PP01.12 - Laser-Integrated Real-Time Optical Coherence Tomography (Li-Oct) In Femtosecondlaser-Assistant Cataract Surgery – A Pilot Study

Laser-Integrated Real-Time Optical Coherence Tomography (Li-Oct) In Femtosecondlaser-Assistant Cataract Surgery – A Pilot Study

Published 2022 - 40th Congress of the ESCRS

Reference: PP01.12 | Type: Free paper | DOI: 10.82333/q4xt-f637

Authors: Sebastian Siebelmann* 1 , Robert Hörster 1 , Claus Cursiefen 2 , Mario Matthaei 2 , José Güell 3 , Tobias Neuhann 4 , Raphael Neuhann 4

1Ophthalmology,EyeCenter Erkelenz,Erkelenz,Germany;Ophthalmology,University Hospital of Cologne,Cologne,Germany, 2Ophthalmology,University Hospital of Cologne,Cologne,Germany, 3Ophthalmology,Instituto de Microcirugia Ocular (IMO),Barcelona,Spain, 4Ophthalmology,Ophthalmologikum Neuhann,Munich,Germany

Purpose

The Femtosecondlaser-integrated intraoperative OCT (LI) is a new type of intraoperative OCT in which the OCT device is integrated with the laser device.  Femtosecond laser-assisted cataract surgery (FLACS) is a safe and established procedure. Nevertheless, certain complications exist that may be due to dynamic, as yet unexplored processes during laser application. The aim of this pilot study was to use LS-OCT to observe dynamic processes during laser application and to define typical characteristics.

Setting

MVZ ADTC Erkelenz, Erkelenz, Germany, Ophthalmologicum Neuhann, Munich, Germany, Department of Ophthalmology, University Hospital of Cologne, Germany.

Methods

In this feasibility study, videos of real-time imaging using femtosecond laser-integrated intraoperative OCT (Victus, Bausch and Lomb) were retrospectively analyzed in 65 consecutive patients (65 eyes, 48 patients) regarding the gained information during the different steps of laser application and the associated dynamic processes within the anterior eye chamber. In addition, the information obtained with the laser was correlated with the settings used later during phacoemulsification and lens implantation.

Results

All surgical steps could be successfully visualized by LI-OCT in all investigated eyes. In general, typical changes in the anatomical configuration of the anterior chamber, the lens as well as the iris-lens diaphragm were observed depending on the different phases of laser application. In particular, the generation and propagation of gas within the capsular bag appears to have a direct effect on the configuration of the structures in the anterior chamber.  In addition, the degree of lens hardness could be assessed intraoperatively by using OCT. 

Conclusions

LI-OCT, as a novel imaging technology is capable of acquiring intraoperative real time image data during all steps of FLACS especially regarding the gas generation and distribution. In the future the real time surveillance of these image data by algorithms or artificial intelligence could decrease the incidence of complications like capsular block syndrome or intraoperative miosis.