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. 2016 Oct-Dec;11(4):452-454.
doi: 10.4103/2008-322X.194150.

Intraoperative Optical Coherence Tomography Guided Bleb Needling

Tanuj Dada  1 , Dewang Angmo  1 , Neha Midha  1 , Talvir Sidhu  1
Affiliations

Intraoperative Optical Coherence Tomography Guided Bleb Needling

Tanuj Dada et al. J Ophthalmic Vis Res. 2016 Oct-Dec.

Abstract

Two patients with history of trabeculectomy presented with uncontrolled intraocular pressure (IOP) postoperatively. The first patient had a flat and vasularized bleb 10 weeks after the surgery, and the second subject developed encapsulated bleb 3 months postoperatively. Both patients were taken to the operating room and intraoperative optical coherence tomography (OCT) guided bleb needling was performed to restore aqueous egress into the subconjunctival space. Postoperatively, IOP of the operated eyes ranged 14-18 mmHg at week 6 and month 3. None of the eyes had any intraoperative or postoperative complications. This novel application of the intraoperative OCT for bleb needling facilitates precision surgery under direct visualization and reduces the risk of complications.

Keywords: Bleb Needling; Encysted Bleb; Optical Coherence Tomography.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Intra-operative clinical photograph showing a flat vascularised bleb. The corresponding live iOCT imaging- horizontal scan (blue horizontal line) and vertical scan (red vertical line) of the bleb area shows apposition of the conjunctiva and sclera with minimal hyporeflective space, indicating a fibrosed/non-filtering bleb with 26 G needle in situ (white asterisk). (b) Intraoperative OCT (iOCT) imaging showing a relatively diffusely raised bleb with multiple hypo-reflective spaces post bleb needling, with 26 G needle in situ (white asterisk).
See this image and copyright information in PMC

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