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Abstract #72654 Published in IGR 18-4
Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries
Pasricha ND; Bhullar PK; Shieh C; Viehland C; Carrasco-Zevallos OM; Keller B; Izatt JA; Toth CA; Challa P; Kuo ANIndian Journal of Ophthalmology 2017; 65: 57-59
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.
Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
Full articleClassification:
12.20 Other (Part of: 12 Surgical treatment)
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)