SPOTLIGHT ON TECHNOLOGY & TECHNIQUE

Enjoying the view

Zeiss’ Rescan 700 gives surgeons a real-time feedback system through microscope integration.

By Corrie Pelc, Contributing Editor

For ophthalmologists who value efficiency and compact design, the Rescan 700 combines Zeiss’ OPMI Lumera 700 microscope with an incorporated intraoperative OCT (iOCT) system.

“It has an integrated spectral-domain OCT system in the microscope,” says Justis Ehlers, MD, the Cleveland Clinic-Cole Eye Institute in Ohio.

This system provides intraoperative imaging, a heads-up display of the OCT data and external visualization of the OCT on the microscope’s display screen.

HOW IT WORKS

Dr. Ehlers says the microscope is designed to function independently. “Ergonomically, it’s virtually unchanged from the standard Lumera 700 microscope.”

The OCT system is controlled through either a foot pedal or a screen on the side of the microscope — doctors push a button to toggle between the microscope and OCT control. When in microscope mode, the system operates and behaves like a standard microscope. However, when OCT mode is activated, Dr. Ehlers says the OCT system begins scanning. Also, the doctor can view the surgical field through either the heads-up display or side panel screen.

“And you can move it to whatever area of interest, whether it’s the retina using one of the lens systems or the cornea if you’re just going to be directly scanning with the OCT,” he explains.

Zeiss’ Rescan 700 combines Zeiss’ OPMI Lumera 700 microscope with an integrated intraoperative OCT system.

PRACTICE BENEFITS

After using the Zeiss Rescan 700 in his practice for over a year, Dr. Ehlers has found iOCT to be very helpful during certain anterior segment keratoplasty procedures, such as DSAEK, DMEK and DALK. “With DALK [surgeons] could look at, for example, the depth of their initial dissection and the OCT could give them feedback for that.”

Surgeons can use the OCT-provided data to have a better understanding of the surgical field, monitor progress and verify results. For example, Dr. Ehlers says the OCT could help surgeons see whether any residual fluid needs to be removed during a corneal graft. Conversely, the OCT might show that the corneal graft was perfectly opposed and no further action is needed.

On the retina side, the Rescan 700 can aid in membrane-peeling procedures, such as epiretinal membranes or macular holes, Dr. Ehlers says. Again, the OCT can help surgeons see if a residual membrane needs more peeling or if the surgical objective was reached. “It is surprising how often our normal surgeon’s view doesn’t necessarily go along with what the OCT shows us.”

The iOCT system is particularly helpful in guiding surgical maneuvers if surgeons do not have a good view of the surgical field, such as in retinal surgery that also involves a cataract or corneal edema. Dr. Ehlers adds that patients with media opacity or corneal scarring would not be good candidates for OCT.

CONCLUSION

Along with offering a helpful view of the surgical field, Dr. Ehlers says the Zeiss Rescan 700 can be used as a tool to explain medical conditions to patients. More patients are asking to see their OCT scans, he says, so now physicians have a way to better explain the condition and the necessity for surgery.

“Patients feel reassured to hear that we have the potential to have this type of technology at the time of surgery to confirm whether we got all the scar tissue off and to be able to look at things in a different way from just the standard microscope view.”

Although viewing the additional informatio might slightly increase case time, Dr. Ehlers says it can help lower overall case time by showing a surgeon he has done everything that was needed.

“It really gives you a level of assurance regarding achieving your surgical objectives,” Dr. Ehlers says. “I think it’s a really exciting field, and I think it’s something that we’re going to be using more and more in ophthalmic surgery.” OM