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DISCOVER study shows feasibility, usefulness of intraoperative OCT
According to 3-year results of the DISCOVER study, microscope-integrated intraoperative OCT during ophthalmic surgery is feasible and useful as it relates to surgical decision-making.
The large-scale study enrolled 837 eyes, of which 244 eyes were enrolled in the anterior segment arm and 593 eyes were enrolled in the posterior segment arm.
In 216 patients in the anterior segment arm, intraoperative OCT provided valuable feedback, most frequently when evaluating the graft-host apposition and when assessing the extent of interface fluid in Descemet’s stripping automated endothelial keratoplasty and Descemet’s membrane endothelial keratoplasty. In 106 patients, the information resulted in changes to surgical decision-making.
In the posterior segment arm, intraoperative OCT was identified as adding valuable surgical information in 352 patients. Added value was related to the procedure, surgical anatomic features or both. In 173 patients, the added value directly affected the surgical procedure.
“The DISCOVER study has demonstrated both the feasibility and usefulness of [intraoperative] OCT as it relates to surgical decision-making in both anterior and posterior segment surgery,” the study authors wrote. – by Robert Linnehan
Disclosures: Ehlers reports he is a consultant for Bioptigen, ThromboGenics, Genentech, Leica, Zeiss, Alcon; receives financial support from ThromboGenics, Genentech, Alcon, Regeneron, Aerpio and Boehringer-Ingelheim; and has patents with Bioptigen and Leica.
Perspective
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The role of intraoperative OCT (iOCT) in the evaluation of vitreoretinal pathology during surgery is much better understood today compared with its introduction in our operating rooms just several years ago. Since 2013, we have seen numerous papers published describing how iOCT enhances what we do during retinal surgery. Retina specialists are finally starting to process this flood of data.
As with any new technology in ophthalmology, such as OCT angiography, it takes time to understand the clinical impact of implementation on decision-making and patient outcomes. Initial publications focused on niche uses for iOCT and benefits of implementation for specific diseases. Ehlers and colleagues at the Cleveland Clinic have taken the lead, through the DISCOVER iOCT study, to provide our community with prospective data, which demonstrate both generalized feasibility and usefulness of this technology based on the surgeon-reported impact on surgical decision-making. This large-scale study confirmed findings from other studies as well as from our own center on the value and impact of iOCT on ophthalmic surgery.
The community will certainly benefit from the outstanding published and ongoing work by Ehlers and colleagues in this landscape as it adds clarity to the role of iOCT in our operating rooms.