scholarly journals Optical Coherence Tomography Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Masaki Tanito

Introduction. Intraoperative observation of ocular structures using microscope-integrated optical coherence tomography (iOCT) has been adopted recently. I report my initial feasibility assessment of iOCT for the incised trabecular meshwork observation during microhook ab interno trabeculotomy. Case Series. Both the nasal and temporal sides or either side of the trabecular meshwork/inner wall of Schlemm’s canal was incised more than 3 clock hours. After then, under observation using a Swan-Jacob gonioprism lens with the real-time 5-line scan mode, OCT images of the area were successfully acquired in 10 (83%) of 12 sides in nine eyes. Based on the appearance of the acquired images of the 10 sides, the trabeculotomy cleft could be classified into three incisional patterns, that is, six (60%) anterior-opening patterns (posterior-based flap), three (30%) middle-opening patterns (posterior- and anterior-based flaps), and one (10%) posterior-opening pattern (anterior-based flap), according to the predominant locations of the trabecular meshwork flaps. Conclusion. Intraoperative observation of the gonio structures including the trabeculotomy cleft was feasible using the RESCAN 700 in combination with a gonioprism.

2015 ◽  
Vol 6 (2) ◽  
pp. 216-222 ◽  
Author(s):  
Hiroshi Kunikata ◽  
Toru Nakazawa

Objective: To report intraoperative optical coherence tomography (iOCT)-assisted 27-gauge microincision vitrectomy surgery (MIVS) in eyes with vitreoretinal disease. Methods: A retrospective, interventional case series performed at a single center, including 6 eyes with retinal disease that underwent iOCT-assisted 27-gauge MIVS. Results: The advantages of iOCT were most notable when it was used to evaluate, in real time, different macular areas: the pre-macula, in vitreomacular traction or epiretinal membrane; the intra-macula, in macular edema or macular hole; and the sub-macula, in macular detachment. Real-time imaging and the minimization of shadows cast on the underlying tissues by the 27-gauge instrumentation made it possible to quickly select the best procedure at each critical juncture of the surgery. No patients experienced any complications. Conclusion: Real-time iOCT imaging during 27-gauge MIVS provided excellent intraoperative visualization of retinal tissues without causing significant obstructions to the surgeon. The positive feedback from the system allowed the surgeon to better judge the necessity of additional surgical procedures.


2021 ◽  
pp. 247412642199733
Author(s):  
Kyle D. Kovacs ◽  
M. Abdallah Mahrous ◽  
Luis Gonzalez ◽  
Benjamin E. Botsford ◽  
Tamara L. Lenis ◽  
...  

Purpose: This work aims to evaluate the clinical utility and feasibility of a novel scanning laser ophthalmoscope-based navigated ultra-widefield swept-source optical coherence tomography (UWF SS-OCT) imaging system. Methods: A retrospective, single-center, consecutive case series evaluated patients between September 2019 and October 2020 with UWF SS-OCT (modified Optos P200TxE, Optos PLC) as part of routine retinal care. The logistics of image acquisition, interpretability of images captured, nature of the peripheral abnormality, and clinical utility in management decisions were recorded. Results: Eighty-two eyes from 72 patients were included. Patients were aged 59.4 ± 17.1 years (range, 8-87 years). During imaging, 4.4 series of images were obtained in 4.1 minutes, with 86.4% of the image series deemed to be diagnostic of the peripheral pathology on blinded image review. The most common pathologic findings were chorioretinal scars (18 eyes). In 31 (38%) eyes, these images were meaningful in supporting clinical decision-making with definitive findings. Diagnoses imaged included retinal detachment combined with retinoschisis, retinal hole with overlying vitreous traction and subretinal fluid, vitreous inflammation overlying a peripheral scar, Coats disease, and peripheral retinal traction in sickle cell retinopathy. Conclusions: Navigated UWF SS-OCT imaging was clinically practical and provided high-quality characterization of peripheral retinal lesions for all eyes. Images directly contributed to management plans, including laser, injection or surgical treatment, for a clinically meaningful set of patients (38%). Future studies are needed to further assess the value of this imaging modality and its role in diagnosing, monitoring, and treating peripheral lesions.


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