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    Microscope-integrated OCT provides 3-D images in real-time

    Next-generation intrasurgical imaging uses swept-source device

    Dr. Hahn

    Durham, NC—Intrasurgical imaging using a swept-source, microscope-integrated optical coherence tomography (MIOCT) device is the latest advance in OCT technology that has positively impacted intraoperative human retinal imaging during vitreoretinal surgery.

    More in this issue: New instrumentation advances vitrectomy surgery

    Intraoperative OCT imaging has been pioneered at Duke University, Durham, NC, by a team led by Cynthia Toth, MD, professor of ophthalmology and bioengineering, and Joseph Izatt, PhD, professor of bioengineering.

    “The increased speed and tracking of our next-generation swept-source MIOCT device addresses many of the deficiencies of current intraoperative spectral-domain (SD) platforms and enables seamless real-time, three-dimensional (3-D) imaging of instrument-retina interactions for the first time,” said Paul Hahn, MD, PhD, speaking about the swept-source MIOCT prototype unit developed at Duke University.

    A number of different types of OCT imaging systems are available for use intraoperatively, but they come with their downsides. A particular handheld SD-OCT instrument (Envisu, Bioptigen) that is approved by the FDA can indeed be used intraoperatively, he noted.

    “Much of our current data on intraoperative OCT comes from handheld devices, but they require stopping surgery and therefore cannot obtain real-time OCT images around a moving instrument,” said Dr. Hahn, assistant professor of ophthalmology, Duke Eye Center, Duke University School of Medicine.



    (Figure 1)  Individual line scans capturing a surgical maneuver (top row) may provide information about retina-instrument interactions but are very difficult to interpret out of context. Real-time 3-D volume scans, acquired with a prototype Duke swept-source, based microscope-integrated OCT system, enable improved visualization and contextual perception. (Figure courtesy of Paul Hahn, MD, PhD)

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