Optical Coherence Tomography Observation of Gonio Structures during Microhook Ab Interno Trabeculotomy

Figure 1

iOCT during μLOT. (a) Intraoperative findings during microhook ab interno trabeculotomy. Under observation using a Swan-Jacob gonioprism lens, a microhook is inserted into Schlemm’s canal. In this case of the left eye, temporal angle is being incised with the microhook that was inserted from the nasal corneal port. (b) Intraoperative observation of the incised trabecular meshwork and inner wall of Schlemm’s canal by 5-line scans of the RESCAN 700 in combination with a Swan-Jacob gonioprism lens. In this case of the right eye, temporal angle is visualized with iOCT. (c, d, e) Based on the flap locations (white and red arrows), the trabeculotomy cleft is classified into an anterior incisional pattern (c) (seen with posterior-based flaps predominantly), middle incisional pattern (d) (seen with posterior- and anterior-based flaps), or posterior incisional pattern (e) (seen with anterior-based flap predominantly). (f) The trabeculotomy cleft is unclear because the OCT signal is blocked by a blood clot. The white arrow, a posterior-based flap; the red arrow, an anterior-based flap; the blue arrow, a blood clot; and the asterisk, the lumen of Schlemm’s canal.

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