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Intraoperative Optical Coherence Tomography Guided Bleb Needling.

Tanuj Dada1, Dewang Angmo1, Neha Midha1

  • 1Glaucoma Research Facility and Clinical Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Journal of Ophthalmic & Vision Research
|December 21, 2016
PubMed
Summary
This summary is machine-generated.

Intraoperative optical coherence tomography (OCT) guided bleb needling effectively managed uncontrolled intraocular pressure (IOP) after trabeculectomy. This precision technique restored aqueous egress, reducing complications and improving IOP control in two patients.

Keywords:
Bleb NeedlingEncysted BlebOptical Coherence Tomography

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Surgery

Background:

  • Trabeculectomy is a common glaucoma surgery to reduce intraocular pressure (IOP).
  • Postoperative complications like flat or encapsulated blebs can lead to uncontrolled IOP.
  • Managing these complications is crucial for successful glaucoma treatment.

Purpose of the Study:

  • To evaluate the efficacy and safety of intraoperative optical coherence tomography (OCT) guided bleb needling.
  • To restore aqueous humor egress in patients with uncontrolled IOP after trabeculectomy.

Main Methods:

  • Two patients with uncontrolled IOP post-trabeculectomy underwent intraoperative OCT guided bleb needling.
  • OCT provided real-time visualization during the needling procedure to guide instrument placement.
  • Aqueous egress into the subconjunctival space was re-established.

Main Results:

  • Postoperative IOP in the operated eyes ranged from 14-18 mmHg at 6 weeks and 3 months.
  • Both patients experienced successful IOP control without intraoperative or postoperative complications.
  • The procedure facilitated precise surgical intervention under direct visualization.

Conclusions:

  • Intraoperative OCT guided bleb needling is a safe and effective technique for managing bleb-related complications after trabeculectomy.
  • This method enhances surgical precision and minimizes the risk of adverse events.
  • It offers a valuable approach to restoring adequate aqueous outflow and IOP control.