Intraoperative OCT-Assisted Surgical Management of Proliferative Vitreoretinopathy (PVR)

Robert A. Sisk, MD, FACS of Cincinnati Eye Institute demonstrates how he uses the new Proveo 8 with built-in EnFocus OCT to treat proliferative vitreoretinopathy (PVR), which remains a major obstacle for long term success in retinal detachment surgery. Dr. Sisk explains how Intraoperative OCT is a critical tool for surgical decision making in PVR surgery through identification of membrane location, tractional effects on the retina, and surgical planes for membrane peeling.

The opinions expressed in this video are those of the physician.
Their statements do not necessarily reflect the opinion of any institution with whom they are affiliated.

#ophthalmology​ #IntraoperativeOCT​ #retina #PVR #ProliferativeVitreoretinopathy

00:00 – Intraoperative OCT-Assisted Surgical Management of Proliferative Vitreoretinopathy
00:15 – Patient history
00:36 - Intraoperative OCT-assisted PVR surgery
01:58 – Benefits of using Leica Proveo 8 with intraoperative OCT

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▬ Video Transcript ▬▬▬▬▬▬▬▬▬▬▬▬
Intraoperative OCT-Assisted Surgical Management of Proliferative Vitreoretinopathy (PVR)
Robert A. Sisk, MD, FACS

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Multiple opacified bands of vitreous and PVR are observed with radial extensions from a contracted partially separated hyaloid face. The optic nerve and fovea are initially obscured. Core vitrectomy is performed to reduce anterior to posterior traction and segment vitreous bands. A radial retinal fold is seen nasally due to retinal shortening. Triamcinolone acetonide stain facilitated identification of the split posterior hyaloid face. Intraoperative OCT was utilized to identify tractional forces in multiple planes, demonstrate retained posterior hyaloid and epiretinal membranes, and to monitor foveal integrity during membrane removal. The retina was scanned extensively after membrane removal to confirm all epiretinal and vitreous traction was released.

The Leica Proveo 8 with EnFocus HD OCT is a critical new tool for intraoperative surgical decision making and improving my outcomes in PVR surgery. Serial volume scans help the surgeon identify all membranes, even if invisible to traditional microscope optics or biologic stains. The EnFocus HD OCT provides high resolution images that demonstrate the tractional effects on the retina and the surgical planes for membrane peeling. Real-time OCT scanning can monitor for stress on the retina during membrane peeling and confirm the adequacy of membrane removal to reach a surgical endpoint.