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Brought to you as an educational service by This Technology Could Change Eye Surgery traditional corneal transplant. Glaucoma surgeons may use it for stent placement or bleb evaluation. The footprint of the Rescan 700 is inconsequential; it's fully integrated into the Zeiss OPMI Lumera 700 surgical microscope and takes up no more room than the microscope itself. It's easy to use; surgeons use the microscope to focus on the area of interest and then can aim and focus the OCT and control the image in the oculars with a touch of a button. We don't yet have a CPT code for the Rescan 700, but it's a great investment regardless. It's made our surgeons faster; Rescan 700 could easily cut 10-15 minutes off a macular pucker procedure. We believe it is already improving outcomes, although more study is needed. And importantly, we think it has the potential to attract more cases to our center. Already, two new retinal surgeons have applied for privileges. Many new technologies have the power to "wow," but only a select few actually change the standard of care. It's early, but we think intraoperative OCT could land in this elite second category. It has so much power to improve lives that it may ultimately be unthinkable to do certain procedures without it. Apply a tiny piece of cellophane tape to Saran Wrap, then sink both to the bottom of a glass of water. Now, working with tweezers, see if you can peel the tape off of the Saran Wrap without damaging it. Until recently, that's what it's been like to do some kinds of eye surgery, particularly corneal and retinal surgery. It's not just that you're frequently manipulating very thin, very delicate tissue in a very tight space. It's that the tissue is virtually invisible. In our center, though, these procedures just got much easier, safer, and faster. It's all because of a device called the Zeiss Rescan 700. The Rescan 700 employs a technology called optical coherence technology, or OCT. Using a laser, it shines near-infrared light into the eye. The reflections provide a tissue cross-section that's accurate to 5 µm. It's a virtual, real-time biopsy. Using the Rescan 700 during eye surgery, we can perfectly see how we are affecting these hard-to-see transparent tissues in real time as we are working on them. The OCT image is projected in a heads-up display in the oculars of the microscope so that you don't even have to look away from the microscope to make use of this OCT information intraoperatively. Retinal surgeons can see exactly how deep a macular hole is, a key factor in deciding whether or not to do an air-fluid exchange. When peeling a macula, they can see when they've removed all of the internal limiting membrane and should stop. They can precisely assess the edges of a macular pucker, a critical factor in determining post-op care needs. They can work more quickly and more confidently, and achieve better outcomes. We corneal surgeons are using the Rescan 700 to help us attach donor tissue to the corneal endothelium in DSEK and DMEK. With Rescan 700, we can watch the tissue unroll and attach to the cornea. If there is an area of non-attachment, we can see it and decide to inject more air or to refloat the tissue. The traditional success rate with DSEK is about 90%; with DMEK, it's even lower. Rescan 700 should help improve both. We've only been using Rescan 700 for a few months, so we've barely scratched the surface. It may ultimately help us align donor tissue in Intraoperative OCT helps surgeons see what was once invisible. Eric D. Donnenfeld, MD, Carle Place, N.Y. Dr. Donnenfeld is a principal owner and managing partner of the six-OR Island Eye Surgicenter in Carle Place, N.Y., one of the nations 10 busiest surgery centers. He is a past president of the American Society of Cataract and Refractive Surgeons and was the Refractive Surgeon of the Year in 2005. Special thanks to Robert Nelson, PA, Gerard D'Aversa, MD and Daniel Kiernan, MD for their help with this article. The Rescan at work. With the flip of a switch, Daniel Kiernan, MD gets a real-time, cross-sectional view of an epiretinal membrane peel. A D V E R T O R I A L