EyeWorld Asia-Pacific June 2020 Issue

FEATURE 12 EWAP JUNE 2020 surgeons,” Dr. Schallhorn said. “I w˜` ˆÌ “œÃÌ ÕÃivՏ ˆ˜ “Þ VœÀ˜i> cases and have been surprised >Ì Ìˆ“ià LޅœÜ “ÕV…yՈ` ˆÃ left in the graft interface when it looks perfectly attached to me.” An additional use for intraoperative OCT in Dr. Findl’s hands would be for OVD removal. “The problem with OVDs is they are very similar to water—the refractive index of OVD and water is quite similar— so in my hands I don’t see the interface well,” he said. Finally, Dr. Tassignon reiterated the technology’s utility in observing the anterior interface. “It predicts the degree of surgical `ˆvwVՏÌÞ ˆ˜ V>Ãià œv «i`ˆ>ÌÀˆV cataract with anterior interface dysgenesis since in these cases there is an abnormality in the development of the anterior hyaloid and the posterior capsule,” she said. “The repair mechanism to compensate for this dysgenesis resulted in a posterior cataract, which has been recognized as a separate pediatric cataract entity.” Looking forward Intraoperative OCT, Dr. Tassignon said, will hopefully answer remaining questions such as the size of the anterior interface and the role of an AVD on post-cataract cystoid macular edema or retinal detachment. Meanwhile, Dr. Findl hopes for further technological developments, such as an entire eye OCT, perhaps some robotic automation, and plastic instruments that do not cast shadows on OCT images. Something concrete to look forward to is an intraoperative OCT course that Dr. Schallhorn, Charles Lin, MD, and Matthew Feng, MD, are designing for the 2020 ASCRS Annual surgery. This will be a great opportunity to learn about a technology that Dr. Schallhorn expects will have an expanding role in practice. “Because of the unique advantages of OCT over direct visualization (cross- sectional image, longer light wavelength), it adds to the surgeon’s understanding of what is happening during an operation,” she said. “I expect that it will eventually become routine to use OCT during most types of surgery.” EWAP References 1. Tassignon MJ. The history of the anterior interface. Innovative Implantation Technique: Bag-in-the-Lens Cataract Surgery. Springer Nature . 2019:25–32. 2. Tassignon MJ. Clinical variations of the vitreo-lenticular interface. Innovative Implantation Technique: Bag-in-the- Lens Cataract Surgery. Springer Nature . 2019:33–44. 3. Tassignon MJ, Ni Dhubhghaill S. Real- time intraoperative optical coherence ̜“œ}À>«…Þ ˆ“>}ˆ˜} Vœ˜wÀ“à œ`iÀ concepts about the Berger space. Ophthalmic Res. 2016;56:222–226. Editors’ note: Dr. Findl is chair and associate professor of ophthalmology, Hanusch Hospital, Vienna, Austria, and declared relevant interests with Alcon, Johnson & Johnson Vision, and Carl Zeiss Meditec. Dr. Schallhorn is assistant professor of ophthalmology, University of California, San Francisco, and declared relevant interests with Carl Zeiss Meditec. Dr. Tassignon is chair, Department of Ophthalmology, Antwerp University Hospital, Antwerp, Belgium, and has intellectual and proprietary interests in the bag-in-the- lens technique. +OCIG HTQO VJG 4'5%#0 %CTN <GKUU /GFKVGE QH C FKHƂEWNV ECVCTCEV ECUG KP C RCVKGPV with Stevens–Johnson syndrome and a large corneal scar. OCT was helpful in visualiz- ing the capsulorhexis through the dense scar. Source: Julie Schallhorn, MD Meeting. The course will cover the basic design and use of the various commercially available intraoperative OCT microscopes and will include a wet lab for OCT use in lamellar corneal