{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:43:36Z","timestamp":1782301416497,"version":"3.54.5"},"reference-count":38,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Intraoperative optical coherence tomography (iOCT) has emerged as a pivotal technology in anterior segment surgery, particularly in cases limited by corneal opacity, edema, or altered anatomy. By providing real-time, cross-sectional imaging, iOCT enables surgeons to visualize otherwise hidden structures and to perform critical intraocular maneuvers with greater precision and safety. Its integration into the surgical microscope allows continuous monitoring of tissue\u2013instrument interaction, transforming traditionally \u201cblind\u201d procedures into image-guided interventions. This review highlights the role of iOCT in endothelial keratoplasty, deep anterior lamellar keratoplasty (DALK), management of acute corneal hydrops, synechiolysis, glaucoma drainage device implantation, and ocular trauma. In endothelial procedures, iOCT helps confirm Descemet membrane removal, graft orientation, and resolution of interface fluid. In DALK, it facilitates accurate cannula placement, stromal depth assessment, and evaluation of leucoma extension to guide surgical strategy. During hydrops management, iOCT supports precise air\/gas injection and compression suture placement. Additionally, it enhances safety in synechiolysis, shunt implantation, and repair of traumatic corneal injuries.<\/jats:p>","DOI":"10.3390\/bioengineering13010015","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T23:52:27Z","timestamp":1766706747000},"page":"15","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Overcoming Opacity: The Role of Intraoperative OCT in Complex Corneal and Anterior Segment Surgery"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-8608","authenticated-orcid":false,"given":"Natalie","family":"di Geronimo","sequence":"first","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Moramarco","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5148-7643","authenticated-orcid":false,"given":"Vito","family":"Romano","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy"},{"name":"Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2442-4081","authenticated-orcid":false,"given":"Maurizio","family":"Mete","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3877-0417","authenticated-orcid":false,"given":"Luigi","family":"Fontana","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1001\/archopht.1994.01090240090031","article-title":"Micrometer-scale resolution imaging of the anterior eye in vivo with optical coherence tomography","volume":"112","author":"Izatt","year":"1994","journal-title":"Arch. 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