LAUSR

PURPOSE We sought to develop an efficient method for fluorescein angiography (FA) during Digitally Assisted Vitreoretinal Surgery (DAVS). METHODS A 485 nm bandpass filter was placed into the filter holder of the accessory light sources of the Constellation Vision System with steel modified washers to produce an exciter source. A barrier filter was placed into the blank slot of a switchable laser filter with a 535 nm bandpass filter and another washer or created digitally with a specific color channel using NGENUITY Software Version 1.4. Fluorescein, 250-500 mg was then injected intravenously during retinal surgery. RESULTS These fluorescence patterns accurately detect many fluorescein angiography biomarkers such as determination of vascular filling times, ischemia, neovascularization, shunt vessels, microaneurysms, and leakage into the vitreous. This enhanced surgical visualization permitted intervention in real time such as laser or diathermy to residual microvascular abnormalities after delamination of retinal neovascularization as well as heavier panretinal laser placement in areas of retinal capillary dropout to relatively preserve areas of more intact retinal microcirculation. CONCLUSION We are the first to report an efficient method that permits high resolution detection of many classic FA biomarkers such as during DAVS to enhance surgical visualization and intervention in real time.