Intraoperative OCT-Guided Catheter-Assisted Combined 360-Degree Trabeculotomy and Trabeculectomy in a Case of Aphakic Glaucoma

Conclusion Box

Already known:

• Intraoperative optical coherence tomography (iOCT) can be used in a variety of glaucoma surgical techniques.

• The currently commercially available iOCTs with a wavelength of 840 nm are optimised for examination of the cornea and retina.

• The penetration depth of iOCTs using an 840 nm wavelength in the chamber angle remains limited due to scleral shadowing. Higher wavelengths (e.g., 1310 nm) and swept-source technology OCTs seem to be more capable of visualising the trabecular meshwork.

Newly described:

• iOCT can be used during a catheter-assisted 360-degree trabeculotomy and trabeculectomy.

• iOCT was able to identify the formation of a fluid reservoir under the scleral flap as a marker of success and can thus be considered a helpful tool in trabeculotomy surgery.

Publication History

Received: 30 April 2023

Accepted: 04 August 2023

Article published online:
06 September 2023

• References

• 1 Geerling G, Müller M, Winter C. et al. Intraoperative 2-dimensional optical coherence tomography as a new tool for anterior segment surgery. Arch Ophthalmol 2005; 123: 253-257
• 2 Siebelmann S, Cursiefen C, Lappas A. et al. Intraoperative Optical Coherence Tomography Enables Noncontact Imaging During Canaloplasty. J Glaucoma 2016; 25: 236-238
• 3 Swaminathan SS, Chang TC. Use of Intraoperative Optical Coherence Tomography for Tube Positioning in Glaucoma Surgery. JAMA Ophthalmol 2017; 135: 1438-1439
• 4 Kumar RS, Jariwala MU, Sathidevi AV. et al. A Pilot Study on Feasibility and Effectiveness of Intraoperative Spectral-Domain Optical Coherence Tomography in Glaucoma Procedures. Transl Vis Sci Technol 2015; 4: 2
• 5 Dada T, Angmo D, Midha N. et al. Intraoperative optical coherence tomography guided bleb needling. J Ophthalmic Vis Res 2016; 11: 452-454
• 6 Junker B, Jordan J, Framme C. et al. Intraoperative optical coherence tomography and ab interno trabecular meshwork surgery with the Trabectome. Clin Ophthalmol 2017; 11: 1755-1760
• 7 Heindl LM, Siebelmann S, Dietlein T. et al. Future prospects: assessment of intraoperative optical coherence tomography in ab interno glaucoma surgery. Curr Eye Res 2015; 40: 1288-1291
• 8 Juergens L, Michiels S, Borrelli M. et al. Intraoperative OCT – Real-World User Evaluation in Routine Surgery. Klin Monbl Augenheilkd 2021; 238: 693-699
• 9 Smith R. A new technique for opening the canal of Schlemm. Preliminary report. Br J Ophthalmol 1960; 44: 370-373
• 10 Smith R. Nylon filament trabeculotomy in glaucoma. Trans Ophthalmol Soc U K 1962; 82: 439-454
• 11 Beck AD, Lynch MG. 360 degrees trabeculotomy for primary congenital glaucoma. Arch Ophthalmol 1995; 113: 1200-1202
• 12 Mendicino ME, Lynch MG, Drack A. et al. Long-term surgical and visual outcomes in primary congenital glaucoma: 360 degrees trabeculotomy versus goniotomy. J AAPOS 2000; 4: 205-210
• 13 Morales J, Al Shahwan S, Al Odhayb S. et al. Current surgical options for the management of pediatric glaucoma. J Ophthalmol 2013; 2013: 763735
• 14 Sarkisian SR. An illuminated microcatheter for 360-degree trabeculectomy in congenital glaucoma: a retrospective case series. J AAPOS 2010; 14: 412-416
• 15 Temkar S, Gupta S, Sihota R. et al. Illuminated microcatheter circumferential trabeculotomy versus combined trabeculotomy-trabeculectomy for primary congenital glaucoma: a randomized controlled trial. Am J Ophthalmol 2015; 159: 490-497.e2
• 16 El Sayed Y, Gawdat G. Two-year results of microcatheter-assisted trabeculotomy in paediatric glaucoma: a randomized controlled study. Acta Ophthalmol (Copenh) 2017; 95: e713
• 17 Jalil A, Au L, Khan I. et al. Combined trabeculotomy-trabeculectomy augmented with 5-fluorouracil in paediatric glaucoma: CTT with 5-FU for paediatric glaucoma. Clin Exp Ophthalmol 2011; 39: 207-214
• 18 Juergens L, Michiels S, Seiler T. et al. Evaluation der Nutzung von intraoperativer OCT im operativen Alltag: ein 2-Jahres-Vergleich. Klin Monbl Augenheilkd 2023; 2: 158-162
• 19 Hoerauf H, Scholz C, Koch P. et al. Transscleral optical coherence tomography: a new imaging method for the anterior segment of the eye. Arch Ophthalmol 2002; 120: 816-819
• 20 Koc F, Kargi S, Biglan AW. et al. The aetiology in paediatric aphakic glaucoma. Eye (Lond) 2006; 20: 1360-1365
• 21 Toshev AP, Much MM, Klink T. et al. Catheter-assisted 360-Degree Trabeculotomy for Congenital Glaucoma. J Glaucoma 2018; 27: 572-577
• 22 Mills MD, Robb RM. Glaucoma following childhood cataract surgery. J Pediatr Ophthalmol Strabismus 1994; 31: 355-360
• 23 Kang KD, Yim HB, Biglan AW. Comparison of delayed-onset glaucoma and early-onset glaucoma after infantile cataract surgery. Korean J Ophthalmol 2006; 20: 41-46
• 24 Hoskins jr. HD, Shaffer RN, Hetherington J. Anatomical classification of the developmental glaucomas. Arch Ophthalmol 1984; 102: 1331-1336
• 25 Carrasco-Zevallos O, Keller B, Viehland C. et al. Real-time 4D visualization of surgical maneuvers with 100 kHz swept-source Microscope Integrated Optical Coherence Tomography (MIOCT) in model eyes. Invest Ophthalmol Vis Sci 2014; 55: 1633
• 26 Carrasco-Zevallos OM, Viehland C, Keller B. et al. Review of intraoperative optical coherence tomography: technology and applications [Invited]. Biomed Opt Express 2017; 8: 1607-1637