AU - Pasricha, Neel AU - Bhullar, Paramjit AU - Shieh, Christine AU - Viehland, Christian AU - Carrasco-Zevallos, Oscar AU - Keller, Brenton AU - Izatt, Joseph AU - Toth, Cynthia AU - Challa, Pratap AU - Kuo, Anthony TI - Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries PT - BRIE DP - 2017 Jan 1 TA - Indian Journal of Ophthalmology PG - 57-59 VI - 65 IP - 1 4099- https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=2017;volume=65;issue=1;spage=57;epage=59;aulast=Pasricha;type=0 4100- https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=2017;volume=65;issue=1;spage=57;epage=59;aulast=Pasricha AB - 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.