Intraoperative Optical Coherence Tomography to Guide Corneal Biopsy: A Case Report

Abstract

Purpose: To report on a new application of intraoperative optical coherence tomography (OCT) as a real-time imaging tool to help guide corneal biopsy. Methods: Single case report. After the negative result of a corneal biopsy, we used intraoperative OCT during repeat biopsy to assist in depth and acquisition of an anterior stromal opacity suspected to be immunoglobulin deposits. Results: The use of intraoperative OCT is a novel tool, which assisted in successful identification and conservative biopsy of corneal immunoglobulin deposits. Conclusions: Intraoperative OCT is a novel tool that assists in the identification and location of corneal pathology for biopsy.

Anterior Segment Optical Coherence Tomography in Ocular Argyrosis

“…9 Immunoglobulin deposition can also be identified as either anterior or posterior corneal hyperreflective plaques. 10 In the present case, we demonstrate silver localization to both Descemet's membrane as well as Bowman's layer, which is unique among the deposition diseases described. This case report describes the novel use of AS-OCT in ocular argyrosis, suggesting the deposition location of silver in Bowman's membrane in addition to Descemet's membrane.…”

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

“…Thirty-one articles were excluded: 19 were not written in English, 9 were review papers, and 3 were ex vivo studies. After full-text evaluation, 82 studies discussing the use of MI-OCT in ophthalmology were included [ 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , ...…”

“…Finally, other minor applications for MI-OCT are corneal biopsy, corneal ulcer debridement with tuck-in multi-layered amniotic membrane transplantation, corneal Intacts (Addition Technology, Lombard, IL, USA) placement, lamellar keratotomy for Salzmann degeneration, and small incision lenticule extraction, in the case of difficult lenticule extraction [ 13 , 48 , 49 , 50 ]. In the latter case, MI-OCT can provide real-time visualization of lenticule relation with anterior stromal cap and stromal bed [ 50 ].…”

<p>Intraoperative Optical Coherence Tomography Guided Ocular Surgeries: Critical Analysis of Clinical Role and Future Perspectives</p>

“…18 Under complex clinical scenarios, such as the identification of superficial fibrovascular tissue in severe limbal stem cell deficiency, iOCT helps in the discretion of abnormal tissue from normal, thus preventing excessive resection of healthy tissue. 19 Similarly, morphological comprehensibility during phototherapeutic keratectomy, 20 corneal shield ulcer dissection, 21 corneal biopsy, 22 corneal injury repair, 23 and during keratoplasty are all noted to have a positive impact with the iOCT. 24 Furthermore, these applications can be enhanced by contriving the fourdimensional tissue volumetric images 25 (Figures 1 and 2).…”