scholarly journals Microscope-integrated Intraoperative Optical Coherence Tomography for Anterior Segment Surgical Maneuvers

2020 ◽  
Vol 9 (7) ◽  
pp. 18
Author(s):  
Wangyi Fang ◽  
Qingchen Li ◽  
Jinyu Fan ◽  
Ning Tang ◽  
Jian Yu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Intraoperative Optical Coherence Tomography

Intraoperative Optical Coherence Tomography in Children with Anterior Segment Anomalies

Ophthalmology ◽  
2015 ◽  
Vol 122 (12) ◽  
pp. 2582-2584 ◽  
Author(s):  
Sebastian Siebelmann ◽  
Manuel Hermann ◽  
Thomas Dietlein ◽  
Björn Bachmann ◽  
Philipp Steven ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Intraoperative Optical Coherence Tomography

scholarly journals ‘Acute-angled bevel’ sign to assess donor lenticule orientation in ultra-thin descemet stripping automated endothelial keratoplasty

2019 ◽  
Vol 12 (2) ◽  
pp. e227927 ◽  
Author(s):  
Jeewan S Titiyal ◽  
Manpreet Kaur ◽  
Farin Shaikh ◽  
Aafreen Bari
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Acute Angle ◽  
Optical Coherence ◽  
Endothelial Keratoplasty ◽  
Anterior Segment Oct ◽  
Intraoperative Optical Coherence Tomography ◽  
Congenital Hereditary Endothelial Dystrophy ◽  
Graft Insertion

A 6.5-year-old boy with congenital hereditary endothelial dystrophy underwent clear corneal ultra-thin descemet stripping automated endothelial keratoplasty (DSAEK). After graft insertion, it was difficult to assess graft orientation due to hazy cornea. Intraoperative optical coherence tomography (iOCT) showed a well-attached graft and the bevelled edge of donor lenticule made an acute angle with the overlying stroma. Postoperative anterior segment OCT confirmed the presence of acute-angled bevel sign. A wetlab experiment was performed with experimental corneoscleral tissues to confirm the findings. Donor lenticule was injected in the artificial chamber with stromal-side up as well as stromal side-down. ‘Acute-angled bevel sign’ was observed on iOCT in the experimental cases with stromal-side up. In inverse graft, the acute-angled bevel was not observed, instead the configuration was obtuse angled. Identifying the ‘acute-angled bevel sign’ on iOCT confirms correct graft orientation after unfolding and is extremely useful for hazy corneas and ultrathin DSAEK lenticules.

scholarly journals Intraoperative Optical Coherence Tomography Imaging in Corneal Surgery: A Literature Review and Proposal of Novel Applications

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Hiroshi Eguchi ◽  
Fumika Hotta ◽  
Shunji Kusaka ◽  
Yoshikazu Shimomura
Keyword(s):  
Optical Coherence Tomography ◽  
Corneal Transplantation ◽  
Anterior Segment ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Optical Coherence ◽  
Endothelial Keratoplasty ◽  
Corneal Surgery ◽  
Anterior Lamellar Keratoplasty ◽  
Intraoperative Optical Coherence Tomography

Intraoperative optical coherence tomography (iOCT) is widely used in ophthalmic surgeries for cross-sectional imaging of ocular tissues. The greatest advantage of iOCT is its adjunct diagnostic efficacy, which facilitates to decision-making during surgery. Since the development of microscopic-integrated iOCT (MIOCT), it has been widely used mainly for vitreoretinal and anterior segment surgeries. In corneal transplantation, MIOCT allows surgeons to visualise structure underneath the turbid and distorted cornea, which are impossible to visualise with a usual microscope. Real-time visualisation of hard-to-see area reduces the operation time and leads to favorable surgical outcomes. The use of MIOCT is advantageous for a variety of corneal surgical procedures. Here, we have reviewed articles focusing on the utility of iOCT  and MIOCT in penetrating keratoplasty, deep anterior lamellar keratoplasty, Descemet stripping automated endothelial keratoplasty, and Descemet membrane endothelial keratoplasty. The applications of MIOCT to corneal surgery in terms of surgical education for trainees, emergency surgery, and novel surgery are also discussed, with our cases performed using RESCAN® 700.

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.

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 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.

Pediatric Free-floating Anterior Chamber Cyst of the Iris Pigment Epithelium

2018 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Joshua S Agranat ◽  
Yoshihiro Yonekawa
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Incidental Finding ◽  
Pigment Epithelium ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Optical Coherence ◽  
Visual Axis ◽  
Associated Malignancy ◽  
Anatomic Locations

Iris pigment epithelial (IPE) cysts are a subset of iris cysts that arise from the IPE. They are spontaneously erupting epithelial-lined cavities that are found in various anatomic locations of the iris, including the iris pupillary margin, midzone, periphery, and free floating in the vitreous or anterior chamber. We report the case of an asymptomatic 13-year-old boy with an incidental finding of a dislodged anterior chamber cyst diagnosed on routine examination. Modern multimodal image analysis of the cyst including anterior segment optical coherence tomography and ultrasound biomicroscopy (UBM) was utilized to characterize the microstructural anatomy of the lesion. The patient was managed conservatively without complications. Cysts of the IPE typically do not affect vision or ocular health and can be monitored and observed after ascertaining no associated malignancy. Initial diagnostic investigation can include UBM and anterior segment optical coherence tomography. Intervention should be reserved only for cases where the cyst growth leads to obstruction of the visual axis and/or other secondary complications.

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