Multicolor Scanning Laser Ophthalmoscopy Strengthens Surgeons' Preoperative Decision-Making and Intraoperative Performance on Epiretinal Membrane

多色扫描激光眼底镜增强外科医生在视网膜前膜手术中的术前决策和术中操作能力

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Abstract

PURPOSE: To determine whether multicolor scanning laser ophthalmoscopy (MC-SLO) was better than color fundus photography (CFP) to enhance residents and specialists' preoperative decision-making and intraoperative performance on the epiretinal membrane (ERM). METHODS: Consecutive patients with idiopathic ERM were recruited prospectively. All the patients underwent MC-SLO and CFP imagings and were randomized into MC-SLO (n = 20) and CFP (n = 20) groups. Preoperatively, residents and specialists were required to have ERM delineation and select an optimal location for initial ERM peeling independently, based on the MC-SLO (MC-SLO group) or CFP (CFP group) images. Intraoperative optical coherence tomography (iOCT) was introduced to evaluate the accuracy. RESULTS: Preoperatively, residents and specialists acted more effectively in ERM delineation and selection of initial grasping location in the MC-SLO group (both P < 0.001). In the MC-SLO group, higher resident-specialist agreements were achieved in ERM delineation (P = 0.002) and selection of initial grasping location (P = 0.035). The iOCT revealed greater interobserver (iOCT-resident and iOCT-specialist) agreements of ERM delineation in MC-SLO group (P < 0.001 and = 0.027, respectively). Surgeons acted more effectively on completely peeling the ERM in the MC-SLO group (P < 0.001). CONCLUSIONS: MC-SLO provided a better visual reference for residents and specialists in ERM delineation and the selection of an initial grasping location for the surgery, compared with CFP. TRANSLATIONAL RELEVANCE: MC-SLO is able to help surgeons achieve better intraoperative performance and shorten the learning process for residents.

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