Intraoperative OCT improves
ophthalmic surgery
Whereas traditional use of OCT enabled pre- and post-operative views, true integration of
optical coherence tomography (OCT) into surgical microscopy is giving eye surgeons a valuable
new view of their work—and the opportunity to make critical adjustments during surgery.
Themostpopularexamination method in ophthalmology today is optical coherence tomography (OCT). Traditionally, OCT examinations have been
performed pre- and post-operatively in
vitreo-retinal surgery. While this application of the technology has enabled
outcomes to be measured and results to
be documented, surgeons have not had
the ability to incorporate the results to
improve surgical treatments. But with
considerable advances to OCT—
including high-definition OCT (HD OCT), 3D
visualization, and adaptive optics—the
integration of these methods into the surgical microscope is logical.
The technology is now helping ophthalmologists carry out delicate eye sur-geries. In today’s integrated microscopy
systems, OCT uses the optical pathway
of the microscope, giving the physician
seamless and simultaneous control of
both surgical manipulations and OCT
visualization. The result is enhanced
information and control for the surgeon,
and improved outcomes for the patient.
This article is an overview of the currently available commercial devices
available for intraoperative OCT
imaging. Those I have used personally
are described in more detail.
Envisu SDOIS by Bioptigen
Bioptigen’s Envisu spectral-domain oph-
thalmic imaging system (SDOIS) is a
spectral-domain OCT (SD-OCT) system
designed to acquire, process, display, and
save depth-resolved images of ocular tis-
sue microstructure (see Fig. 1). It is pri-
marily intended for the imaging of reti-
nal tissue: It enables researchers to resolve
in fine detail the microstructure of the
retina—such as the nerve fiber layer, the
inner and outer plexiform, and nuclear
SUSANNE BINDER, MD, is Professor and Chair in the Departments of Ophthalmology at
the the Ludwig Boltzmann Institute for Retinology and Biomicroscopic Lasersurgery; and the
Rudolf Foundation Clinic, Teaching Hospital of the Medical University of Vienna (Vienna,
Austria) and Adjunct Professor of Clinical Ophthalmology at the Weill Cornell Medical College
in New York City.
EDITOR’S NOTE: This article is updated
and adapted from S. Binder, Spektrum
der Augenheilkunde, 28, 1, 2–5 (2014),
with permission from Springer.
FRONTIS. Indications for clinical use of Bioptigen’s Envisu system include the evaluation of ophthalmic
tissue in routine clinical examinations and as an aid in the diagnosis of conditions that affect the
optical scattering properties of ocular tissue.
