EVALUATION OF INTRA-OPERATIVE OCT DURING GLAUCOMA SURGERIES

To explore the utility of intra-operative OCT during glaucoma surgeries. 

Monocentric tertiary glaucoma center.

Literature review and monocentric retrospective study with one year of follow-up. We explored intra-operative OCT during different glaucoma surgeries, including classical surgeries (deep sclerectomy, trabeculectomy, tube), micro-invasive glaucoma surgeries (MIGS) and less-invasive glaucoma surgeries (LIGS), as well as their utility helping the surgeon.

Different surgeries were performed using intra-operative OCT, namely trabeculectomy, deep sclerectomy, and Ahmed and Baerveldt tubes. Intra-operative OCT was useful to guide the thickness of the trabeculodescemetic window in deep sclerectomy and to evaluate position of the tubes. LIGS surgeries (including XEN, Preserflo and MIMS) were also performed with intra-operative OCT. In MIGS surgery, intra-operative OCT allowed the identification of the trabeculotomy of GATT surgery (gonioscopy-assisted transluminal trabeculotomy), the correct intra-canalicular positioning of an Hydrus and event iStents, but had difficulties in identifying the trabeculostomies of ELIOS and the microsclerostomy of the MIMS.

Despite not being fundamental, intra-operative OCT has allowed a deeper evaluation of glaucoma surgeries. It is very useful to novice surgeons. The bleb evaluation can be more complete thanks to intra-operative OCT. Deep sclerectomy, tubes, and Preserflo are surgeries in which intra-operative OCT is particularly useful. Developing an OCT that can work through the surgical gonioscopy lenses will be even more useful. Further studies are needed to assess better characterize its utility.