Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries.
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.
Duke Scholars
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Related Subject Headings
- Trabeculectomy
- Tomography, Optical Coherence
- Surgery, Computer-Assisted
- Ophthalmology & Optometry
- Male
- Intraocular Pressure
- Imaging, Three-Dimensional
- Humans
- Glaucoma
- Anterior Chamber
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Trabeculectomy
- Tomography, Optical Coherence
- Surgery, Computer-Assisted
- Ophthalmology & Optometry
- Male
- Intraocular Pressure
- Imaging, Three-Dimensional
- Humans
- Glaucoma
- Anterior Chamber