title: Comparison of a remote operating slit-lamp microscope system with a conventional slit-lamp microscope system for examination of trabeculectomy eyes.
abstract: OBJECTIVE
  To compare 2-dimensional (2D) photo imaging with slit-lamp photo imaging for examination of trabeculectomy eyes, and to compare the accuracy and consistency of examination of trabeculectomy eyes with a remote operating slit-lamp microscope system (referred to as "remote slit lamp" hereafter) and a conventional slit-lamp microscope system (referred to as "slit lamp" hereafter).
  
  
  METHODS
  Thirty-five eyes of 35 patients having a history of trabeculectomy were enrolled in the study that compared 2D photo imaging with slit-lamp photo imaging for the evaluation of trabeculectomy eyes. Five ophthalmologists evaluated the 2D images and the slit-lamp images independently with masking of patient information. Evaluation scores were compared with those provided by a glaucoma specialist using the slit lamp as standard. Fifteen eyes from 15 patients having a history of trabeculectomy were enrolled in the study that investigated the accuracy and consistency of examination of trabeculectomy eyes with a remote slit lamp and a slit lamp.
  
  
  RESULTS
  Central anterior chamber depth, bleb height, and bleb extent evaluated by the slit-lamp photo imaging showed significantly higher consistency with the standard than those evaluated by 2D photo imaging (P<0.05). The remote slit lamp showed good consistency of all the evaluated parameters with the slit lamp and the κ scores of all the evaluated parameters were higher than 0.8. The completion time for evaluation with the remote slit lamp and the slit lamp were 247.3±153.5 and 123.5±53.7 seconds, respectively (P<0.001).
  
  
  CONCLUSIONS
  Slit-lamp photo imaging is a superior method for examination of trabeculectomy eyes compared with 2D photo imaging. The remote slit-lamp system shows similar potential to the slit-lamp system for the evaluation of trabeculectomy eyes, although the evaluation time is much longer.
authors.affiliation: Department of Community and Family Medicine, Interdisciplinary School of Medicine and Engineering, University of Yamanashi, Kofu, Yamanashi, Japan. kenjik@yamanashi.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Kashiwagi
authors.forename: Naohiko
authors.initials: N
authors.lastname: Tanabe
authors.forename: Kentaro
authors.initials: K
authors.lastname: Go
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Imasawa
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Mabuchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Chiba
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugiyama
authors.forename: Keitetsu
authors.initials: K
authors.lastname: Abe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003695:Delivery of Health Care / Q000379:methods; D003952:Diagnostic Imaging; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008853:Microscopy / Q000295:instrumentation*; D008875:Middle Aged; D019114:Remote Consultation / Q000379:methods*; D019113:Telepathology; D014130:Trabeculectomy; D055815:Young Adult