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

Area of Science:

• Ophthalmology
• Medical Imaging
• Surgical Technology

Background:

• Glaucoma is a leading cause of irreversible blindness.
• Elevated intraocular pressure (IOP) is a primary risk factor for glaucoma progression.
• Current surgical interventions for severe glaucoma include tube shunt placement and trabeculectomy.

Observation:

• The study introduces the first intraoperative use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT) for live four-dimensional (4D) imaging.
• SS-MIOCT was employed during tube shunt placement and trabeculectomy surgeries in two patients with severe, medically refractory open-angle glaucoma.
• The technology provided direct visualization of critical surgical steps, including scleral tunneling, tube shunt positioning, scleral flap creation, sclerotomy, and iridectomy.

Findings:

• SS-MIOCT successfully visualized key intraoperative surgical maneuvers in both tube shunt placement and trabeculectomy.
• The enhanced visualization provided by SS-MIOCT was particularly beneficial for surgical steps requiring precise depth-based assessments.
• Both patients achieved their target IOP goals postoperatively, indicating successful surgical outcomes.

Implications:

• SS-MIOCT offers a significant advancement in intraoperative imaging for ophthalmic surgery.
• This technology has the potential to improve surgical precision and patient outcomes in glaucoma management.
• Further research may explore the broader application of SS-MIOCT in other complex ophthalmic procedures.