Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes

• Published in: Investigative ophthalmology & visual science Vol. 57; no. 9; pp. OCT146 - OCT153
• Main Authors: Todorich, Bozho, Shieh, Christine, DeSouza, Philip J, Carrasco-Zevallos, Oscar M, Cunefare, David L, Stinnett, Sandra S, Izatt, Joseph A, Farsiu, Sina, Mruthyunjaya, Privthi, Kuo, Anthony N, Toth, Cynthia A
• Format: Journal Article
• Language: English
• Published: United States The Association for Research in Vision and Ophthalmology 01.07.2016
• Subjects: Anterior Eye Segment - surgery; Clinical Competence; Eye Diseases - diagnosis; Eye Diseases - surgery; Female; Humans; Imaging, Three-Dimensional; Internship and Residency - methods; Male; Microscopy - methods; Microsurgery - education; Microsurgery - methods; Monitoring, Intraoperative - methods; Ophthalmology - education; Prospective Studies; Surgery, Computer-Assisted - education; Surgery, Computer-Assisted - methods; Tomography, Optical Coherence - methods
• ISSN: 1552-5783; 0146-0404; 1552-5783
• DOI: 10.1167/iovs.15-18818

The integration of swept-source optical coherence tomography (SS-OCT) into the operating microscope enables real-time, tissue-level three-dimensional (3D) imaging to aid in ophthalmic microsurgery. In this prospective randomized controlled study, we evaluated the impact of SS microscope-integrated OCT (MI-OCT) on ophthalmology residents' performance of ophthalmic microsurgical maneuvers. Fourteen ophthalmology residents from a single institution were stratified by year of training and randomized to perform four anterior segment surgical maneuvers on porcine eyes with (MI-OCT+) or without (MI-OCT-) direct intraoperative OCT guidance. Subsequently, both groups repeated the same maneuvers without MI-OCT feedback to test whether initial MI-OCT experience affected subsequent surgical performance. Finally, the MI-OCT- group was crossed over and allowed to repeat the same maneuvers with direct MI-OCT guidance. Each resident completed a survey at the completion of the study. With direct MI-OCT feedback, residents demonstrated enhanced performance in depth-based anterior segment maneuvers (corneal suture passes at 50% and 90% depth and corneal laceration repair) compared with the residents operating without MI-OCT. Microscope-integrated OCT+ residents continued to outperform the controls when both groups subsequently operated without MI-OCT. For clear corneal wound geometry, there was no statistically significant effect of MI-OCT as applied in this study. Overall, the resident surgeons rated their subjective experience of using MI-OCT very favorably. Microscope-integrated OCT feedback enhances performance of ophthalmology residents in select anterior segment surgical maneuvers. Microscope-integrated OCT represents a valuable tool in the surgical education of ophthalmology residents.