RWC 2025: Alan J. Franklin, MD, PhD on the use of intraoperative fluorescein angiography

Alan J. Franklin, MD, PhD spoke with the Ophthalmology Times team at Retina World Congress 2025. This meeting is taking place in Fort Lauderdale, Florida, from May 8-11, 2025.

In this conversation, Franklin discussed a research study on intraoperative fluorescein angiography in surgical procedures, highlighting significant advancements in surgical visualization and patient outcomes. The key research finding centers on using fluorescein angiography during surgery to identify and laser areas of fluorescein leakage or occult neovascularization. By targeting these specific areas, the team demonstrated a substantial reduction in postoperative vitreous hemorrhage rates and notable improvements in patient visual acuity during the first 3 months after surgery.

The technique's historical development is briefly traced, starting with Dr. Charles's initial work on operating microscopes, which initially struggled with wide-angle visualization. This was advanced for heads-up surgery, and the current research team further streamlined the process using retinal machines and heads-up displays. Franklin emphasized that while compelling visual imagery is important, the ultimate goal is demonstrating tangible patient benefits.

Drawing from personal fellowship training experience, he also noted the historical difference between fellows and attending physicians in surgical visualization with the experienced surgeons traditionally able to better identify and navigate surgical pathologies. Modern digital imaging systems now provide enhanced tissue visualization, allowing for more precise surgical interventions. The research aimed to formally compare surgical outcomes between patients who underwent intraoperative fluorescein angiography and those who did not. The study's action items include:

• Analyzing data on intraoperative fluorescein angiography's impact
• Comparing patient outcomes
• Preparing the research for publication

The research represents a significant advancement in surgical techniques, leveraging technological improvements to potentially improve surgical precision and patient outcomes.