[Intraoperative optical coherence tomography for examination of newborns and infants under general anesthesia]

Abstract

Background: Examination of newborn and children under general anesthesia is essential to prevent amblyopia and blindness; however, the validity was often limited due to a lack of state of the art diagnostic tools in the intraoperative set-up, e. g. optical coherence tomography (OCT). Since OCT devices have been integrated into surgical microscopes, this technique is also available for examination with patients under general anesthesia.

Objective: To give an overview about the possibilities of intraoperative OCT (iOCT) during examination of newborn and infant children under general anesthesia.

Material and methods: Analysis of recent literature (PubMed) and initial experiences at the Center for Ophthalmology of the University Hospital of Cologne.

Results: The use of iOCT enables real-time high-resolution imaging during examinations of children under general anesthesia. All relevant structures of the anterior eye segment (including cornea, lens, chamber angle and iris) can be visualized. Especially when the anterior chamber view is limited due to corneal opacifications, iOCT can deliver important information in addition to that obtained using a surgical microscope. This information is important for the further therapy of the patients.

Conclusion: Online iOCT is a useful extension of the normal surgical microscope, especially for examination of children under general anesthesia and limited view into the anterior chamber. In our experience it also makes sense to transfer this technique to anomalies of the posterior pole because high-resolution imaging of the macula and optic nerve head is possible.

Keywords: Amblyopia; Anesthesia, general; Anterior chamber; Microscope; Surgical procedures.