title: The value of intraoperative optical coherence tomography imaging in vitreoretinal surgery.
abstract: OBJECTIVE
  To evaluate the role of intraoperative optical coherence tomography (iOCT) in vitreoretinal surgery, assess the current state-of-the art, and to examine possible future directions in the field.
  
  
  RESULTS
  Numerous vitreoretinal surgical conditions and procedures have been described utilizing iOCT. These conditions include macular holes, epiretinal membranes, retinal detachments, and retinopathy of prematurity. Significant alterations appear to occur during surgical manipulations in many of these conditions that can be identified with iOCT. The most common current systems used are portable OCT probes that are either mounted to a microscope or used in a handheld fashion. Prototypes are also being utilized that are integrated into the microscope to allow for true 'real-time' imaging of instrument-tissue interactions. Current generation surgical instrument materials (e.g., metal) limit optimal visualization with integrated OCT systems because of shadowing and light scattering properties.
  
  
  CONCLUSIONS
  The role of iOCT in vitreoretinal surgery continues to be defined by active research and enhancements to integrative technologies. Further research is needed to better define the specific applications of iOCT that impact patient outcomes and surgical decision-making. Future advancements in integrative systems, OCT-friendly instrumentation, and software algorithms will further expand the horizon of iOCT in the vitreoretinal surgical theater. As OCT transformed the clinical management of the vitreoretinal conditions, iOCT has the potential to be a paradigm-shifting technology in the operating room.
authors.affiliation: Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Justis P
authors.initials: JP
authors.lastname: Ehlers
authors.forename: Yuankai K
authors.initials: YK
authors.lastname: Tao
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Srivastava
mesh_terms: D000465:Algorithms; D006801:Humans; D007432:Intraoperative Period; D041623:Tomography, Optical Coherence / Q000379:methods*; D057586:Vitreoretinal Surgery / Q000295:instrumentation / Q000379:methods*