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BRIEF COMMUNICATION
Year : 2017  |  Volume : 65  |  Issue : 1  |  Page : 57-59

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


1 Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
2 Department of Biomedical Engineering, Duke University, Durham, NC, USA
3 Department of Ophthalmology, Duke University School of Medicine; Department of Biomedical Engineering, Duke University, Durham, NC, USA

Correspondence Address:
Anthony Nanlin Kuo
Duke University Eye Center, DUMC Box 3802, Durham, NC 27710
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_412_16

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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.


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