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

作者：Pasricha Neel Dave; Bhullar Paramjit Kaur; Shieh Christine; Viehland Christian; Carrasco Zevallos Oscar Mijail; Keller Brenton; Izatt Joseph Adam; Toth Cynthia Ann; Challa Pratap; Kuo Anthony Nanlin^*

来源：Indian Journal of Ophthalmology, 2017, 65(1): 57-U81.

DOI：10.4103/ijo.IJO_412_16

• Intraoperative imaging
• optical coherence tomography
• swept-source
• trabeculectomy
• tube shunt

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.

• 出版日期2017-1