Optical Coherence Tomography - Rescan During Dissection of Macular Membranes

Study Overview
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Brief Summary
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In our study , the investigators will use the microscope with OCT ( Lumera with RESCAN OCT ) coupled to assess the extent , depth and change of retinal architecture in the perioperative period . Thus , they will evaluate what the optimal maneuvers of dissection of macular membranes to obtain a more satisfactory result of the rearrangement in the retinal layers . Furthermore , the use of OCT perioperative may dispense with the use of dyes , decreasing the concentration used or reduce the exposure time. Thus, they can get the potential decrease in retinal toxicity may be generated by them.

Detailed Description
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The investigators will use the microscope with OCT (Lumera with RESCAN OCT) coupled to assess the extent, depth and change of retinal architecture in the perioperative period. Thus, they will evaluate what the optimal maneuvers of dissection of macular membranes to obtain a more satisfactory result of the rearrangement in the retinal layers. Furthermore, the use of OCT perioperative may dispense with the use of dyes, decreasing the concentration used or reduce the exposure time. Materials and methods The investigators will evaluate 30 patients with changes in macular membranes with surgical removal of indication from the Retina and Vitreous outpatient sector of Unifesp - Paulista School of Medicine. The patients will be classified according to the diseases in the following groups: Macular Hole, Epiretinal Membrane, Traction Syndrome vitreomacular, and proliferative vitreoretinopathy of Retinal Detachment. Everyone will be informed about the risks and benefits of the study and sign an informed consent form. In the preoperative evaluation a complete ophthalmologic examination with complementary tests such as angiography and optical coherence tomography will be done. Patients will undergo retinal surgery using the Lumera Microscope WITH RESCAN OCT - ZEISS. The team of surgeons will answer the questionnaire on the surgical difficulty regarding the identification and removal of macular membranes. All patients will be assessed at 1, 7, 15, 30, 60 and 90 and 180 days after surgery, including the following tests: Measurement of visual acuity with best correction Previous Biomicroscopy Indirect Funduscopy tonometry Optical coherence tomography (OCT) Retinography Surgeries and procedures of the study groups will be conducted by the same team of surgeons and all surgeries and procedures will be carried out in IPEPO - Paulista Institute of Studies and Research in Ophthalmology / Vision Institute. For each type of retinal disease, there will be a control group and a group OCT as detailed below: 1 - GROUP CONTROL The control group will undergo retinal surgery with conventional microscope without coupled OCT. This group will have its filmed and documented surgery. The team of surgeons will answer the questionnaire on the surgical difficulty regarding the identification and removal of macular membranes. 2 -GROUP OCT / RESCAN In the group microscope coupled to OCT, patients will undergo retinal surgery using the Lumera Microscope WITH RESCAN OCT - ZEISS and have their filmed and documented surgery. The team of surgeons will answer the questionnaire on the surgical difficulty regarding the identification and removal of macular membranes. Statistical methodology All information will be presented by mean and standard deviation for the quantitative variables and absolute frequency (n) and relative (%) for qualitative variables.

Official Title
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Evaluation Use Optical Coherence Tomography - Rescan During Dissection of Macular Membranes : Pre and Post Operative Aspects

Conditions
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Macular Hole, Epiretinal Membrane, Traction Syndrome Vitreomacular, Proliferative Vitreoretinopathy

Intervention / Treatment
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* Procedure: Lumera Microscope with OCT RESCAN
* Procedure: Conventional Microscope


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Visual acuity less than 20/60 in the affected eye 18 years of both sexes 1 diagnostics of the diseases Macular Hole,Epiretinal membrane,Traction Syndrome vitreomacular, vitreoretinopathy Proliferative Retina Detachment. Indication of vitreoretinal surgery Exclusion criteria: Any previous eye surgery in the study eye Better visual acuity than or equal to 20/60. Any previous infection affecting any eye structure. transport costs and feeding of patients will be the responsibility of the researchers.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Lumera Microscope with OCT RESCAN<br>in the group microscope coupled to OCT, patients will undergo retinal surgery using the Lumera microscope with Rescan OCT Zeiss | Procedure: Lumera Microscope with OCT RESCAN<br>* macular membrane dissection with OCT RESCAN<br>|
| Other: Conventional Microscope<br>control group without OCT RESCAN | Procedure: Conventional Microscope<br>* macular membrane dissection without OCT RESCAN<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assess optimal maneuvers in macular membrane dissection | by a questionnaire responded by surgeons (no difficulty, some difficulty, very difficulty) | Day 0 (surgical day) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compare the time of surgery between groups | by a questionnaire responded by surgeons (until 1 hour, between 1-2 hours, more than 2 hours | Day 0 (surgical day) | 
| describe the surgical difficulty for macular membrane dissection | by a questionnaire responded by surgeons (no difficulty, some difficulty, very difficulty) | Day 0 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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retina surgery, image guided surgery, optical coherence tomography assisted