title: A Pilot Study on Feasibility and Effectiveness of Intraoperative Spectral-Domain Optical Coherence Tomography in Glaucoma Procedures.
abstract: OBJECTIVE
  To demonstrate the use of a spectral-domain optical coherence tomography (SDOCT) integrated surgical microscope in glaucoma surgery.
  
  
  METHODS
  An SDOCT system was used to interface directly with an ophthalmic surgical microscope, to allow real-time intraoperative SDOCT (iOCT) imaging during glaucoma procedures like phaco-trabeculectomy, Ahmed glaucoma valve (AGV) implantation, gonio-synechiolysis, and bleb needling. The various surgical steps during glaucoma surgeries whereiOCT can be of potential help in guiding the surgeon were recorded.
  
  
  RESULTS
  High-resolution, cross-sectional images of the relevant structures were achieved with theiOCT system in all procedures. The surgeon could determine the depth of the scleral dissection, the intrastomal bed, the path of the AGV tube in the eye, the release of peripheral anterior synechiae and the efficacy of needling with respect to breakage of loculations; most of these are technically 'blind' procedures, where the outcomes are determined postoperatively. Metallic instruments cast a shadow on tissues below, thereby restricting the use of the device in its current state.
  
  
  CONCLUSIONS
  TheiOCT system provided high quality, intraoperative, real-time imaging, which could possibly improve the safety and efficacy of the surgical procedures in glaucoma. Further studies and modifications to theiOCT are required to better understand and increase the uptake of this technology in daily practice.
  
  
  CONCLUSIONS
  TheiOCT, with further advancements in its technology, could potentially provide the surgeon both quantitative and qualitative, real-time depth and tissue proximity details, thus improving the safety and accuracy of glaucoma surgery.
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Rajesh S
authors.initials: RS
authors.lastname: Kumar
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Manan U
authors.initials: MU
authors.lastname: Jariwala
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Sathidevi A
authors.initials: SA
authors.lastname: V
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Jayasree P
authors.initials: JP
authors.lastname: Venugopal
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Narendra K
authors.initials: NK
authors.lastname: Puttaiah
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Ramgopal
authors.initials: R
authors.lastname: Balu
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Dhanaraj
authors.initials: D
authors.lastname: Rao A S
authors.affiliation: Narayana Nethralaya Eye Hospital, Bangalore, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Shetty
keywords: glaucoma; glaucoma drainage implant; optical coherence tomography; trabeculectomy