Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries.

TitleFour-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries.
Publication TypeJournal Article
Year of Publication2017
AuthorsPasricha, ND, Bhullar, PK, Shieh, C, Viehland, C, Carrasco-Zevallos, OM, Keller, B, Izatt, JA, Toth, CA, Challa, P, Kuo, AN
JournalIndian Journal of Ophthalmology
Volume65
Issue1
Start Page57
Pagination57 - 59
Date Published01/2017
Abstract

We report the first use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT) capable of live four-dimensional (4D) (three-dimensional across time) imaging intraoperatively to directly visualize tube shunt placement and trabeculectomy surgeries in two patients with severe open-angle glaucoma and elevated intraocular pressure (IOP) that was not adequately managed by medical intervention or prior surgery. We performed tube shunt placement and trabeculectomy surgery and used SS-MIOCT to visualize and record surgical steps that benefitted from the enhanced visualization. In the case of tube shunt placement, SS-MIOCT successfully visualized the scleral tunneling, tube shunt positioning in the anterior chamber, and tube shunt suturing. For the trabeculectomy, SS-MIOCT successfully visualized the scleral flap creation, sclerotomy, and iridectomy. Postoperatively, both patients did well, with IOPs decreasing to the target goal. We found the benefit of SS-MIOCT was greatest in surgical steps requiring depth-based assessments. This technology has the potential to improve clinical outcomes.

DOI10.4103/ijo.ijo_412_16
Short TitleIndian Journal of Ophthalmology