Intraoperative OCT for inverted ILM flap technique

PurposeTo evaluate the use of intraoperative spectral‐domain optical coherence tomography (iSD‐OCT) for large macular hole (MH) surgery using inverted internal limiting membrane (ILM) flap technique.MethodsWe analyzed 7 consecutive cases of iSD‐OCT assisted pars plana vitrectomy (PPV) with inverted ILM flap technique for large and chronic MHs. iSD‐OCT was performed using Rescan 700 (Zeiss, Oberkochen, Germany). iSD‐OCT data were post‐processed and analyzed postoperatively (study of tissue behavior).ResultsIn all cases iSD‐OCT imaging allowed the surgeon to carry on the procedure without significant time consumption. The iSD‐OCT imaging assisted: 1) to find the safe place on the retina while starting ILM peeling; 2) to control the formation of the inverted ILM flap; 3) to conduct the inversion of the ILM flap over MH. iSD‐OCT allowed to keep safe positioning of the vitreoretinal instruments.ConclusionsiSD‐OCT is a strong supporting tool during PPV, that gives prompt information about tissue behavior and surgical maneuvers. Inverted ILM flap technique for large MH can be performed in more controlled and save way without interruption of the surgical workflow.