Real-Time Assessment of Intraoperative Vaulting in Implantable Collamer Lens and Correlation with Postoperative Vaulting

2016 ◽  
Vol 27 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Jeewan S. Titiyal ◽  
Manpreet Kaur ◽  
Suman Sahu ◽  
Namrata Sharma ◽  
Rajesh Sinha
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Implantable Collamer Lens ◽  
Paired Samples ◽  
Snellen Visual Acuity ◽  
Intraoperative Optical Coherence Tomography ◽  
The Mean

Purpose To assess the intraoperative vaulting in patients undergoing implantable collamer lens (ICL) implantation with microscope-integrated intraoperative optical coherence tomography (iOCT) and correlate it with the postoperative vaulting. Methods Forty eyes of 22 consecutive patients undergoing ICL implantation were prospectively evaluated. Vaulting was measured intraoperatively using microscope-integrated iOCT. The ICL-lenticular relationship was dynamically assessed throughout the surgery. Postoperative vaulting was measured using anterior segment optical coherence tomography on the first postoperative day and after 1 month and compared with the intraoperative vaulting. Uncorrected and best-corrected Snellen visual acuity, intraocular pressure (IOP), and anterior and posterior segments were assessed in all cases. Results The mean central vaulting noted intraoperatively was 558.4 ± 122.8 µm. Postoperative mean vaulting was 576.0 ± 131.2 µm on day 1 and 551.1 ± 122.5 µm on day 30. There was a significant correlation between the intraoperative and the postoperative day 1 vaulting (paired samples correlation: 0.969, p<0.001) and day 30 vaulting (paired samples correlation: 0.945, p<0.001). An ICL-lenticular touch was not noted at any time during the surgery. The postoperative course was uneventful and no patient developed raised IOP or lenticular changes by the last follow-up. Conclusions Intraoperative vaulting correlates well with postoperative vaulting and can aid in on-table detection of extremes of vaulting and decision-making. It enhances the safety of the surgical procedure by providing a real-time display of the intraoperative manipulations.

scholarly journals Role of anterior segment optical coherence tomography in the evaluation of microbial keratitis

2021 ◽  
Vol 7 (3) ◽  
pp. 548-553
Author(s):  
Isha Chaturvedi ◽  
Kamaljeet Singh ◽  
Jagriti Rana ◽  
Kshama Dwivedi ◽  
Reena Sachan
Keyword(s):  
Optical Coherence Tomography ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Morphological Characteristics ◽  
Objective Evaluation ◽  
Response To Treatment ◽  
Optical Coherence ◽  
Microbial Keratitis ◽  
The Mean

Anterior segment optical coherence tomography (AS-OCT) is a newer technology that provides two-dimensional images of corneal infiltration. This study was undertaken to assess whether AS-OCT can aid objective evaluation and response to treatment in resolving microbial keratitis. This prospective study was performed on 17 patients of who underwent slit lamp and AS-OCT examination at presentation and follow up on days 3, 7, 14, 28 and 6 weeks. A standardized scanning protocol was used to measure the corneal thickness (CT) and infiltrate thickness (IT) using the caliper tool of a commercially available AS-OCT device. The mean CT in the infiltrated area and mean IT, both were thickest at presentation (710.88 um and 288.76 um respectively). The mean CT decreased to 665.12 µm, 650.24 µm, 584.35 µm, 549 µm, 507.47 µm on days 3, 7, 14, 28 and 6 weeks respectively. Similarly, the mean IT decreased to 287.24 µm, 244.41 µm, 197 µm, 174.59 µm and 154.82 µm. Paired t- test was used to calculate the statistical change in CT and IT, which was significant (p&#60;0.0001) at 6 weeks, at the rate of 0.67% and 1.01% per day. AS-OCT can show morphological characteristics of microbial keratitis and give quantitative assessment at every follow up.

scholarly journals Intraoperative Optical Coherence Tomography Using the RESCAN 700: Preliminary Results in Collagen Crosslinking

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Natasha Pahuja ◽  
Rohit Shetty ◽  
Chaitra Jayadev ◽  
Rudy Nuijts ◽  
Bharath Hedge ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Imaging Study ◽  
Software Tool ◽  
Optical Coherence ◽  
Average Depth ◽  
Collagen Crosslinking ◽  
Intraoperative Optical Coherence Tomography ◽  
The Mean

Purpose. To compare the penetration of riboflavin using a microscope-integrated real time spectral domain optical coherence tomography (ZEISS OPMI LUMERA 700 and ZEISS RESCAN 700) in keratoconus patients undergoing accelerated collagen crosslinking (ACXL) between epithelium on (epi-on) and epithelium off (epi-off).Methods. Intraoperative images were obtained during each of the procedures. Seven keratoconus patients underwent epi-on ACXL and four underwent epi-off ACXL. A software tool was developed using Microsoft.NET and Open Computer Vision (OpenCV) libraries for image analysis. Pre- and postprocedure images were analyzed for changes in the corneal hyperreflectance pattern as a measure of the depth of riboflavin penetration.Results. The mean corneal hyperreflectance in the epi-on group was 12.97 ± 1.49 gray scale units (GSU) before instillation of riboflavin and 14.46 ± 2.09 GSU after AXCL (P= 0.019) while in the epi-off group it was 11.43 ± 2.68 GSU and 16.98 ± 8.49 GSU, respectively (P= 0.002). The average depth of the band of hyperreflectance in the epi-on group was 149.39 ± 15.63 microns and in the epi-off group it was 191.04 ± 32.18 microns.Conclusion. This novelin vivo, real time imaging study demonstrates riboflavin penetration during epi-on and epi-off ACXL.

Anterior segment optical coherence tomography angle and vault analysis after toric and non-toric implantable collamer lens V4c implantation in patients with high myopia

2017 ◽  
Vol 102 (4) ◽  
pp. 544-548 ◽  
Author(s):  
Guillermo Garcia-De la Rosa ◽  
Andrew Olivo-Payne ◽  
Juan Carlos Serna-Ojeda ◽  
Maria Sandra Salazar-Ramos ◽  
Alejandro Lichtinger ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
High Myopia ◽  
Anterior Segment ◽  
Case Series ◽  
Optical Coherence ◽  
Implantable Collamer Lens ◽  
Iridocorneal Angle ◽  
Lighting Conditions ◽  
Icl V4c

ObjectiveTo assess anterior segment changes, including iridocorneal angle and vault, after toric and non-toric implantable collamer lens (ICL) V4c (STAAR Surgical AG) implantation under different lighting conditions.MethodsLongitudinal, prospective, case series. Patients with high myopia (>6 dioptres) underwent toric and non-toric ICL V4c implantation. Optical coherence tomography measurements were taken under different lighting conditions preoperatively and at 1 week and 1, 6 and 12 months of follow-up.ResultsSeventy-six eyes of 42 patients underwent ICL V4c implantation. Mean age was 27.4 years (±5.14 years, range 20 to 39 years). The average iridocorneal angle showed a statistically significant decrease (p<0.05) in all mesopic, scotopic and photopic conditions after 1 week of surgery compared with the preoperative measurements; in mesopic conditions, it decreased 14.1°, in photopic conditions 14.8° and scotopic conditions 13.2°. The angle measurement had a statistically significant change only in mesopic conditions (p=0.01) over the 1-year follow-up. The average vault under mesopic conditions was 0.661±0.21 mm at week 1. The vault measurement change was statistically significant over the 1-year follow-up in mesopic conditions (p=0.01). Refractive results showed a significant improvement in both uncorrected and corrected distance visual acuity (p<0.001).ConclusionThere is a significant reduction in the iridocorneal angle after ICL V4c implantation. Furthermore, there is a change under mesopic conditions in both the iridocorneal angle and vault during long-term follow-up.

scholarly journals Automatic intraoperative optical coherence tomography positioning

2020 ◽  
Vol 15 (5) ◽  
pp. 781-789 ◽  
Author(s):  
Matthias Grimm ◽  
Hessam Roodaki ◽  
Abouzar Eslami ◽  
Nassir Navab
Keyword(s):  
Optical Coherence Tomography ◽  
Standard Deviation ◽  
Ex Vivo ◽  
Anterior Segment ◽  
Semantic Segmentation ◽  
Recognition Algorithm ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Intraoperative Optical Coherence Tomography ◽  
The Mean

Abstract Purpose Intraoperative optical coherence tomography (iOCT) was recently introduced as a new modality for ophthalmic surgeries. It provides real-time cross-sectional information at a very high resolution. However, properly positioning the scan location during surgery is cumbersome and time-consuming, as a surgeon needs both his hands for surgery. The goal of the present study is to present a method to automatically position an iOCT scan on an anatomy of interest in the context of anterior segment surgeries. Methods First, a voice recognition algorithm using a context-free grammar is used to obtain the desired pose from the surgeon. Then, the limbus circle is detected in the microscope image and the iOCT scan is placed accordingly in the X–Y plane. Next, an iOCT sweep in Z direction is conducted and the scan is placed to centre the topmost structure. Finally, the position is fine-tuned using semantic segmentation and a rule-based system. Results The logic to position the scan location on various anatomies was evaluated on ex vivo porcine eyes (10 eyes for corneal apex and 7 eyes for cornea, sclera and iris). The mean euclidean distances (± standard deviation) was 76.7 (± 59.2) pixels and 0.298 (± 0.229) mm. The mean execution time (± standard deviation) in seconds for the four anatomies was 15 (± 1.2). The scans have a size of 1024 by 1024 pixels. The method was implemented on a Carl Zeiss OPMI LUMERA 700 with RESCAN 700. Conclusion The present study introduces a method to fully automatically position an iOCT scanner. Providing the possibility of changing the OCT scan location via voice commands removes the burden of manual device manipulation from surgeons. This in turn allows them to keep their focus on the surgical task at hand and therefore increase the acceptance of iOCT in the operating room.

scholarly journals Intraoperative Optical Coherence Tomography-Guided Bleb-sparing Epithelial Exchange: A Modified Approach

2021 ◽  
Author(s):  
Dewang Angmo ◽  
Jyoti Shakrawal ◽  
Ramanjit Sihota
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Real Time ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Direct Visualization ◽  
Operating Microscope ◽  
Surgical Time ◽  
Intraoperative Optical Coherence Tomography ◽  
Intraoperative Oct

With the advent of newer technologies, real-time anterior segment optical coherence tomography (OCT) integrated with the operating microscope has become possible. We are proposing the technique of bleb revision with greater precision under direct visualization of bleb anatomy and extent of tissue depth allowing better localization and easy maneuvering with lesser complications. In this surgical technique, bleb revision was performed using intraoperative real-time OCT incorporated in OPMI LUMERA 700 microscope. Live surgical and OCT view were seen on a common screen together. A moderately elevated, diffuse functional bleb was noted after three months of bleb revision in both cases with controlled intraocular pressure. Intraoperative OCT-guided bleb-sparing epithelial exchange is an adjunctive technique for bleb repair surgery with an increased precision of surgery which can reduce complications, minimize surgical time and maximize surgical outcome.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

scholarly journals Changes in anterior segment optical coherence tomography following pars plana vitrectomy without tamponade

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Alireza Khodabande ◽  
Massood Mohammadi ◽  
Hamid Riazi-Esfahani ◽  
Shahab Karami ◽  
Massood Mirghorbani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Optical Coherence ◽  
Mean Values ◽  
Iop Measurement ◽  
Pars Plana ◽  
The Mean

Abstract Background To evaluate changes in anterior segment morphology on anterior segment optical coherence tomography (AS-OCT) following pars plana vitrectomy (PPV) without tamponade. Methods Patients who underwent PPV without tamponade for epiretinal membrane were evaluated. Eligible patients underwent intraocular pressure (IOP) measurement and AS-OCT preoperatively as well as 1 month and 6 months post-operatively. Anterior chamber width (ACW), anterior chamber depth (ACD), trabecular iris angle (TIA), angle opening distance at 500 and 750 µm (AOD), and trabecular iris space area at 500 and 750 µm (TISA) at four quadrants were recorded and analyzed. Additionally, the mean values of TIA (MTIA), AOD (MAOD), and TISA (MTISA) for each eye (mean of four quadrants) were analyzed. Results 23 patients completed the study. The mean age of participants was 56.4 ± 3.6 years of age and 13/23 (56%) were female. Mean IOP of patients was 18.1 ± 1.1, 18.3 ± 1.1, and 18.1 ± 1.2 preoperatively,1 month post-operatively, and 6 months post-operatively, respectively. (p = 0.83). No difference was detected post-operatively in measurements of ACW, ACD, MTIA, MAOD500, MAOD750, MTISA500, and MTISA750. Conclusion Pars plana vitrectomy without tamponade was not associated with changes in anterior chamber morphology.

Spontaneous attachment of complex Descemet’s membrane detachment following multiple failed interventions

2021 ◽  
Vol 14 (8) ◽  
pp. e243960
Author(s):  
Shikha Gupta ◽  
Karthikeyan Mahalingam ◽  
Tushar Agarwal
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Corneal Transplant ◽  
Optical Coherence ◽  
Initial Attempt ◽  
Ocular Tissues ◽  
Surgical Interventions ◽  
Complicated Cataract ◽  
First Time

We describe a case with complex Descemet membrane detachment (DMD) which persisted despite initial two failed surgical attempts to appose the ocular tissues. However, over time, tissue alignment was obtained spontaneously. A 60-year-old woman, operated trabeculectomy, had a total DMD intraoperatively during a complicated cataract surgery. Initial attempt to DM repositioning with intracameral air injection failed. Anterior Segment Optical Coherence Tomography (ASOCT) showed detachment of both DM and pre-Descemet’s layer (PDL). After consultation with a corneal surgeon, patient was again attempted for Intra-operative Optical Coherence Tomography (iOCT)-guided settlement of DMD with intracameral air which again failed. So, the patient was registered for lamellar corneal transplant, but at 3 months follow-up, DM had spontaneously attached, confirmed on ASOCT. This case shows for the first time that even complex DMDs involving PDL, can spontaneously appose despite failed surgical interventions.

scholarly journals Correlation between Central Corneal Thickness and Degree of Myopia among Malaysian Patients Undergoing Laser Keratorefractive Surgery

2020 ◽  
pp. 52-58
Author(s):  
Sagili Chandrasekhara Reddy ◽  
Mohd Mansor Shariff ◽  
Aina Malindri Dasrilsyah
Keyword(s):  
Optical Coherence Tomography ◽  
Refractive Surgery ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Military Hospital ◽  
Moderate Degree ◽  
Optical Coherence ◽  
Corneal Refractive Surgery ◽  
The Mean

Purpose: To determine the central corneal thickness in myopic adult patients scheduled for laser corneal refractive surgery and to explore its correlation with degree of refractive error. Materials and Methods: The case records of 130 myopic patients who underwent laser corneal refractive surgery in a military hospital over a period of two years were reviewed to determine the central corneal thickness. All patients had 6/6 vision with best correction, and did not have any other anterior segment or fundus diseases in both eyes. The central corneal thickness was measured with Visante Carl Zeiss anterior segment optical coherence tomography instrument.                                                                                                                        Results: Out of 130 patients, males were more (73, 56.2%); mean age of patients was 33.8 years (range 18-60 years) and majority were Malays (110, 84.6%).  The spherical power of myopia ranged from – 0.5 to – 10.00 D, and the cylindrical power ranged from – 0.25 to – 3.25 D. The mean central corneal thickness of both eyes was 528.2 µm (range 331- 615 µm); in the mild degree of myopia (- 0.50 to - 2.00 D) 527.9 µm, moderate degree (- 2.25 to -5.00 D) 529.4 µm, and high degree (-5.25 to -11.00 D) 523.9 µm. Conclusion: The anterior segment optical coherence tomography provides noncontact, rapid, pachymetry mapping of the corneal thickness. In Malaysian patients, the mean central corneal thickness of both eyes in myopia was 528.1 µm (range 331- 615 µm). There was no correlation between the mean central corneal thickness and degree of myopia, different genders, age groups, ethnic groups and two eyes.

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