Intraoperative optical coherence tomography guided bleb needling

• DOI: 10.4103/2008-322x.194150
• Publication Date: 2016-11-15T11:03:52Z
• Authors: Dewang Angmo; Tanuj Dada; Neha Midha; Talvir Sidhu
• Keywords: Ophthalmology; 03 medical and health sciences; 0302 clinical medicine; RE1-994; Surgical Technique; Bleb Needling; Optical Coherence Tomography; Encysted Bleb

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.