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

    Next-generation intrasurgical imaging uses swept-source device


    In addition to the Duke MIOCT unit, other microscope-integrated OCT devices include the Haag-Streit iOCT and the Zeiss RESCAN 700.  None of these devices is currently commercially available in the United States.

    The major advantage of microscope-integration is the shared optical path with the surgical microscope that enables OCT image acquisition simultaneously with surgical maneuvers. The previous-generation Duke device and all current devices are spectral-domain OCT based, which have allowed visualization of only individual line scans during surgery.

    “These individual scans can be very difficult to interpret out of context,” Dr. Hahn said.

    Recently, the Duke team finished incorporating next-generation technology into their MIOCT, including use of a swept-source OCT engine to replace the previous spectral-domain engine along with customized tracking hardware and software to target the OCT beam in real -time to a desired area of interest in the retinal tissue.

    Dr. Hahn and colleagues obtained MIOCT images concurrently with surgical manipulations in both model eye systems and in human patients undergoing macular surgery using this next-generation device.

    “The lightning-fast speed of our swept-source OCT engine allows us to obtain many individual scans in the time it previously took to obtain one,” Dr. Hahn said. “As a result, we can view individual line scans but can now see the retina in three-dimensional volumes in real time—which adds so much more information compared with visualization of a single scan as with other spectral-domain systems,” Dr. Hahn said.

    In commenting on the current and future directions, Dr. Hahn said, “MIOCT facilitates an understanding of real-time intrasurgical changes in vitreoretinochoroidal anatomy and their impact on visual outcomes.

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