Intraoperative OCT-assisted vitreoretinal surgery

Purpose: comparative analysis of clinical and functional results of surgery of vitreomacular interface and rheg-matogenous retinal detachment with the use of intraoperative optical coherence tomography. Material and Methods. Clinical and morphofunctional data were analyzed in 102 patients with epiretinal fibrosis (ERF), idiopathic macular hole (IMH), and rhegmatogenous retinal detachment (RRD), who were divided into 2 groups. In the main group (n=52), the surgery was performed using intraoperative ОСТ control, in the control group without it. In the main group intraoperative control was performed at 4 stages of the surgery: before vitrectomy, after vitrectomy, during the main stage of the surgery and after completion of endotamponade of the vitreous cavity. During surgery for macular disorders intraoperative complications were assessed, in RRD the intraoperative screening for the detection of undiagnosed pathological changes was performed. In the postoperative period, clinical and functional results were assessed in up to 6 months. Results. The use of intraoperative ОСТ control allowed to reduce the frequency of intraoperative complications, such as capillary retinal bleeding (19.2% in the control group, 11.5% in the main group) and pinching of the inner retinal layers (not observed in the main group, in the control group its incidence was 23.1%) in macular surgery. Intraoperative ОСТ made it possible to better identify concomitant retinal pathology (secondary epiretinal membranes in the main group were found during the surgery in 11.5% of cases, in the control group in 4.2%, while in the postoperative period in 12.5%). In complicated cases of RDD, tomographic control allows to identify microstructural features of the posterior pole of the eye, which are important in achieving stability of the anatomical result, such as retinal defects over staphyloma of the posterior pole in high myopia cases. Conclusion. Intraoperative OCT-assisted vitreoretinal surgery reduces the rate of intraoperative complications during macular surgery and gives valuable diagnostic information in complicated retinal detachment cases.