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

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Pasricha, ND; Bhullar, PK; Shieh, C; Viehland, C; Carrasco-Zevallos, OM; Keller, B; Izatt, JA; Toth, CA; Challa, P; Kuo, AN

Published Date

  • January 2017

Published In

Volume / Issue

  • 65 / 1

Start / End Page

  • 57 - 59

PubMed ID

  • 28300743

Electronic International Standard Serial Number (EISSN)

  • 1998-3689

International Standard Serial Number (ISSN)

  • 0301-4738

Digital Object Identifier (DOI)

  • 10.4103/ijo.ijo_412_16

Language

  • eng