Purpose of Review: The purpose of this study is to summarize recent updates and discuss emerging technologies related to intraoperative optical coherence tomography (OCT) for posterior segment surgery. Recent Findings: The development of microscope-integrated OCT technology has expanded the potential applications for intraoperative OCT in the operating room. Research has continued to support the potential impact of intraoperative OCT on surgical decision-making and the overall perceived value by surgeons for utilizing intraoperative OCT during vitreoretinal surgery. In addition, recent research in intraoperative OCT has expanded to emerging surgical procedures such as image-guided Argus II retinal prosthesis implant, subretinal gene/cell delivery, and transretinal retinochoroidal biopsy. Technology advancements, including software technologies, prototype non-metallic OCT compatible surgical instruments, and real-time 3-D OCT (4-D OCT) device using swept source technology have been developed. The recent emergence of digital surgery provides an additional opportunity for image-guided surgery utilizing real-time intraoperative OCT overlays onto 3-D digital visualization system for a comprehensive digital surgical theater. Summary: Image-guided surgery with intraoperative OCT continues to evolve and expand as the technology becomes more refined and more widely available. Continued research is needed to further validate the role for image-guided surgery in enhancing surgical outcomes.
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