In this video, Dr. Rachid Tahiri explains the benefits of using the EnFocus intraoperative OCT system for cataract incision analysis. He explains the advantages of using this imaging system, including accurate assessment of the incision architecture throughout the surgical procedure, which allows him to achieve optimal precision during cataract surgery.

Dr. Rachid Tahiri is an ophthalmic surgeon at the Centre d’Ophtalmologie in Granville, France
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Disclaimer: The statements and explanations of the healthcare professional in this video reflect only his opinion and personal experience. His statements don’t necessarily reflect the opinion of any institution with whom he is affiliated.

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▬ Transcript ▬▬▬▬▬▬▬▬▬▬▬▬

00:00 Intro
My name is Rachid Tahiri. I use intraoperative OCT Leica Deep EnFocus for one year. Here, I present another interesting use of intraoperative OCT. It might provide a valuable information about incision construction in cataract surgery.

00:27 Intraoperative OCT
In these examples, intraoperative OCT can give accurate and precise information about the incision architecture from the start of the surgery. We can clearly determine the incision length, the thickness of both superficial and deep flaps. We can perform analysis both in the longitudinal and transversal sections.

00:54 Incision
Here, we can analyze the architecture of the incision at the end of the surgery. Before the hydrosuture, we note that the incision is discretely ovalized on the transversal section.

01:09 Remodeled incision
In this example, the incision is more remodeled. We observe a more marked ovalization in the transversal section. In the longitudinal section, we observe a more direct incision with an internal and an external gap.

01:29 Hydrosuture
We can use intraoperative OCT to analyze changes in the architecture of incision during hydrosuture. We note that the path of the incision disappears, embedded in the corneal edema. Here, we can see an incision before hydrosuture and after hydrosuture.

01:54 Sealed incision
When we analyze a sealed incision, the path of the incision is not visible. We note that the cornea’s anterior curvature remains regular, while a bulging accompanies the corneal edema of the posterior cornea.

02:10 Non-sealed incisions
For non-sealed incisions, despite the completion of the hydrosuture, we note in this case the presence of an internal gaping with a localized Descemet detachment.

02:25 Hydrosuture
In this case, despite the hydrosuture, the path of the incision remains visible. It is interesting to make a transversal section. In this case, we observe that the incision architecture is inclined. That explains why the incision was not sealed.

02:45 Suturing
When suturing a non-sealed incision, its path becomes invisible. It is especially noted that the curvature of the anterior face remains almost unchanged. Then, the modification of curvature mainly concerns the posterior face, which becomes a double bump.

03:09 Outro
In my experience, intraoperative OCT allows very interesting information about incision architecture. It is a great tool that allows finer and more precise analysis. This can improve the quality, the precision and the perfection of cataract surgery.

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