Dataset Information

Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy Using a Novel Digital Microscope with Integrated Intraoperative Optical Coherence Tomography.

ABSTRACT: Purpose:Observation of ocular structures using microscope-integrated intraoperative optical coherence tomography (iOCT) has been adopted. Using the novel digital ophthalmic microscope, ARTEVO 800 with iOCT, we tested the feasibility of trabecular meshwork (TM) imaging during microhook ab interno trabeculotomy, a minimally invasive glaucoma surgery. Methods:The nasal and temporal sides of the TM/inner wall of Schlemm's canal were incised more than 3 clock hours in 14 glaucomatous eyes of 10 patients. To observe the trabeculotomy site, iOCT was performed with the real-time five-line scan mode under observation using a Swan-Jacob gonioprism lens. The success of the imaging and visibility of the trabeculotomy cleft and its incisional patterns (i.e., anterior, middle, or posterior pattern) were determined by reviewing the iOCT video files. Results:OCT images of the region of interest were acquired successfully in 100% of the 28 nasal or temporal sides in 14 eyes, although the trabeculotomy cleft was not visualized in four (14%) sides due to blockage of the OCT signal by a blood clot. Based on the predominant locations of the TM flaps in 24 of the acquired images, the trabeculotomy clefts were classified as anterior incisional patterns in 13 (54%), middle incisional patterns in nine (38%), and posterior incisional patterns in two (8%). Conclusion:Intraoperative imaging of the gonio structures including the trabeculotomy cleft was feasible using the ARTEVO 800 with iOCT in combination with a gonioprism.

SUBMITTER: Ishida A

PROVIDER: S-EPMC7382741 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy Using a Novel Digital Microscope with Integrated Intraoperative Optical Coherence Tomography.

Ishida Akiko A Sugihara Kazunobu K Shirakami Tomoki T Tsutsui Aika A Manabe Kaoru K Tanito Masaki M

Journal of ophthalmology 20200717

<h4>Purpose</h4>Observation of ocular structures using microscope-integrated intraoperative optical coherence tomography (iOCT) has been adopted. Using the novel digital ophthalmic microscope, ARTEVO 800 with iOCT, we tested the feasibility of trabecular meshwork (TM) imaging during microhook ab interno trabeculotomy, a minimally invasive glaucoma surgery.<h4>Methods</h4>The nasal and temporal sides of the TM/inner wall of Schlemm's canal were incised more than 3 clock hours in 14 glaucomatous e ...[more]

PMID: 32724670

Similar Datasets

Project description:To assess the roles of preoperative intraocular pressure (IOP) level on the IOP reducing efficacy of microhook ab interno trabeculotomy (µLOT), 126 consecutive open-angle glaucomatous eyes (90 primary open angle glaucoma, 36 exfoliation glaucoma) of 126 Japanese subjects (60 men, 66 women; mean age ± standard deviation, 70.5 ± 11.4 years) who underwent µLOT alone (25 eyes, 20%) or combined µLOT and cataract surgery (101 eyes, 80%) were retrospectively included, and subdivided into four groups based on the quartile of preoperative IOP: Q1, ≤15 mmHg; Q2, 15-18 mmHg, Q3, 18-21 mmHg, and Q4, >21 mmHg. Preoperative and 12 months postoperative IOPs and numbers of antiglaucoma medications were compared among IOP groups. Factors associated with postoperative IOP were assessed using multivariate analysis, and the success of IOP control was assessed with various definitions. Postoperatively, IOP was significantly higher in Q3 (p < 0.0146) and Q4 (p = 0.0320) groups than Q1 group, while the number of medications was not significantly different among four IOP groups (p = 0.1966). Older age was associated with lower postoperative IOP, and higher preoperative IOP was associated with higher postoperative IOP, while sex, glaucoma type, surgical procedure, lens status, extent of trabeculotomy incision, and preoperative number of medications were not associated with postoperative IOP. The success rates for IOP ≤ 18 and ≤15 mmHg were higher in lower preoperative IOP groups (i.e., Q1 and Q2) than higher preoperative IOP groups (Q3 and Q4), while the success rate for ≥20% IOP reduction was higher in higher preoperative IOP groups than in lower preoperative IOP groups; the success rate for ≥0% IOP reduction was equivalent among groups. By reviewing the previous studies in ab interno trabeculotomy/goniotomy procedures, positive correlation between preoperative and postoperative IOPs was preserved throughout the studies and surgical procedures. After the µLOT, larger %IOP reduction was achieved in higher preoperative IOP groups than in lower preoperative IOP groups, while postoperative IOP was still lower than in lower preoperative IOP groups.

Project description:BackgroundTo examine the risk factors for an early postoperative intraocular pressure (IOP) increase after ab interno trabeculotomy using a Kahook Dual Blade (KDB trabeculotomy).MethodsA retrospective study was performed in 76 exfoliation glaucoma (EXG) eyes and 56 primary open angle glaucoma (POAG) eyes that underwent KDB trabeculotomy, with or without cataract surgery at Kumamoto University Hospital. Postoperative high IOP was classified as IOP≥20 mmHg (within three months after surgery, whether persistent or temporary), transient IOP≥20 mmHg (IOP≥20 mmHg after surgery, then dropped below 20 mmHg), and the presence of IOP spikes (≥ 10 mmHg from baseline). Risk factors were examined using logistic regression analysis.ResultsThe preoperative mean IOP (SD) was 24.98 (7.23) mmHg in patients with EXG and 21.28 (6.58) mmHg in patients with POAG. IOP was reduced by 32.1% in patients with EXG and by 17.7% in patients with POAG at 6 months after surgery. Postoperative IOP≥20 mmHg was observed in 56.6% of EXG patients and in 51.8% of POAG patients. IOP spikes occurred in 15.8% of EXG patients and in 14.3% of POAG patients. Logistic regression analysis showed that factors with significant odds ratios (ORs) were age (OR = 0.866, 95% CI = 0.793-0.945), preoperative medication use (OR = 2.02, 95% CI = 1.17-3.49), trabeculotomy in combination with cataract surgery (OR = 0.0674, 95% CI = 0.015-0.303), and IOP at day 1 (OR = 1.41, 95% CI = 1.18-1.68) for postoperative IOP≥20 mmHg, the IOP at day 1 (OR = 1.1, 95% CI = 1.03-1.17) for transient IOP≥20 mmHg, and age (OR = 0.948, 95% CI = 0.901-0.997) and preoperative IOP (OR = 0.83, 95% CI = 0.736-0.936) for IOP spikes.ConclusionAlthough KDB trabeculotomy is an effective treatment for patients with EXG and POAG, patients who take multiple preoperative medications and have a high IOP on day 1 require careful follow-up to prevent postoperative IOP elevation.

Dataset Information

Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy Using a Novel Digital Microscope with Integrated Intraoperative Optical Coherence Tomography.

Publications

Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy Using a Novel Digital Microscope with Integrated Intraoperative Optical Coherence Tomography.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets