Intraoperative OCT in MIGS - Dr. Bryan Ang скачать в хорошем качестве

Intraoperative OCT in MIGS - Dr. Bryan Ang

The intra-operative optical coherence tomography (iOCT) was introduced to offer better visualization and depth appreciation during ophthalmic surgery, which the traditional surgical microscope lacked, with its only enface intra-operative view. Initially, iOCT systems were portable and handheld. However, modern systems have been integrated with surgical microscopes, improving both platform stability and surgical efficiency. While the iOCT has been most utilized in vitreoretinal and corneal surgeries, its use has also been described in glaucoma surgeries, including trabeculectomy, bleb needling, goniosynechiolysis and glaucoma drainage device implantation. Most recently, the use of the iOCT has been explored in minimally-invasive glaucoma surgery. The iOCT may be used in trabecular bypass MIGS, where it may reduce the risk of over- and under-implantation of the G2/G2W iStent inject; and ensure optimal placement of the Hydrus Microstent, particularly when confirmatory visualization of the three windows of the stent in the Schlemm’s canal post-implantation may be impeded by dense iris processes or a heavily-pigmented trabecular meshwork. The iOCT may also aid in the ab-externo implantation of stents in minimally-invasive bleb surgery, for both the XEN45 Gel Stent and the Preserflo Microshunt. In Preserflo Microshunt implantation, the iOCT can ensure the safe entry of the guide needle through the angle and into the anterior chamber; it may be used to ensure no obvious blockage or occlusion within the stent lumen; and it helps to confirm the safe deployment of the stent just anterior to the iris and away from the cornea, to minimize the risk of endothelial cell loss.