Open AccessFour-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries
Author(s) -
Neel D Pasricha,
Paramjit K Bhullar,
Christine Shieh,
Christian Viehland,
Oscar Carrasco-Zevallos,
Brenton Keller,
Joseph A. Izatt,
Cynthia A. Toth,
Pratap Challa,
Anthony N. Kuo
Publication year - 2017
Publication title -
indian journal of ophthalmology/indian journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 51
eISSN - 1998-3689
pISSN - 0301-4738
DOI - 10.4103/ijo.ijo_412_16
Subject(s) - trabeculectomy , medicine , optical coherence tomography , glaucoma , shunt (medical) , intraocular pressure , glaucoma surgery , visualization , operating microscope , ophthalmology , microscope , surgery , computer science , artificial intelligence , pathology
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.