OCT power package reveals subsurface details during ophthalmic surgery

Wetzlar, Germany. Leica Microsystems will debut the EnFocus intrasurgical optical coherence tomography (OCT) system in combination with its leading Proveo 8 microscope platform at the American Academy of Ophthalmology (AAO) Annual Meeting 2017. The EnFocus OCT system supplements the microscope view with real-time, en face visualization of subsurface ocular tissues to aid ophthalmologists with intrasurgical decision-making.

“Through close collaboration with leading ophthalmic surgeons, we are convinced that OCT will soon become a standard of care in the ophthalmic OR, as it is in the clinic,” says Markus Lusser, President Leica Microsystems. “Studies like the DISCOVER* study underline that intrasurgical OCT provides real-time insights about subsurface ocular tissue which can impact surgical decision-making. The all new combination of EnFocus OCT with the Proveo 8 microscope provides surgeons with an optimal method that delivers this valuable additional information in the best possible quality. We are proud to be at the cutting edge of developments in this exciting technology”.

“For optimal patient outcomes, intrasurgical OCT should be seamlessly integrated into the surgical workflow,” says Maxim Mamin, VP Medical Division at Leica Microsystems. “This is why we’ve combined the real-time, cross-sectional imaging of our leading EnFocus intrasurgical OCT with the premium optics and smart workflow features of the Proveo 8. With this new solution, surgeons will have a comprehensive visualization platform that is intuitive and straightforward to use even during complicated procedures.” 

The smart workflow features of the combined platform include an integrated wireless foot switch, the option to inject OCT images into the binoculars, as well as the ability to display the OCT and microscope view on a large HD heads-up display. This allows surgeons to work autonomously with the EnFocus system without technician support. Dynamic scan control on the foot switch enables swift customization of the OCT angle to align the scan to the membrane tissue being peeled.

Leica Microsystems will showcase EnFocus intrasurgical OCT in combination with the Proveo 8 microscope platform at the American Academy of Ophthalmology (AAO) Annual Meeting, booth 700, from November 11 to 14 in New Orleans, Louisiana. Visitors to the booth can also experience additional integrated digital imaging technologies such as the IOLcompass Pro guidance system and fully synchronized, contact-free, wide angle viewing of the fundus during vitreoretinal surgery with the BIOM 5 accessory from OCULUS.

The EnFocus by Leica Microsystems

EnFocus iOCT is the latest digital technology to be added to the expandable Proveo 8 microscope platform. It will be available for new and installed Proveo systems and can be combined with both floor and ceiling versions.

The EnFocus Ultra HD intrasurgical OCT system combined with the Proveo 8 microscope provides high-resolution (≤ 4 μm) and depth in tissue (up to 2.5mm). EnFocus intrasurgical OCT enables visualization of membrane layers in Vitreomacular Traction (VMT) and macular hole procedures to aid peeling and assessment of surgical endpoint. In advanced cornea lamellar surgeries such as Descemet’s Membrane Endothelial Keratoplasty (DMEK), surgeons have been assisted by intrasurgical OCT when observing donor graft orientation and adherence. The EnFocus Ultra Deep system has increased depth (up to 11.1mm) for a broad range of usage, including assistance with new emerging therapies such as subretinal stem cell therapy.

* The full title of the DISCOVER study is the Determination of feasibility of Intraoperative Spectral domain microscope combined/integrated OCT Visualization during En face Retinal and ophthalmic surgery. The study is being undertaken at the Cole Eye Institute, Cleveland Clinic, Ohio, with Justis P. Ehlers, M.D. as Principal Investigator. The latest findings of the study, using the EnFocus OCT system, showed that “in membrane peeling procedures, intraoperative OCT findings were discordant from the surgeon's initial impression in seven of 20 cases (35%).” (Runkle, Sunil et al, 2017).

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