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Sebastian E Siebelmann, Philipp Steven, Manuel Hermann, Thomas Dietlein, Claus Cursiefen; Intraoperative Optical Coherence Tomography (iOCT) In Newborn And Infant Children With Anterior Segment Anomalies. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4091.
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© ARVO (1962-2015); The Authors (2016-present)
Examination of newborn or infant children with anterior segment anomalies is often challenging due to limited compliance, so that an examination under general anesthesia is preferred. However, intraoperative imaging tools are so far limited. Therefore we evaluated intraoperative Optical Coherence Tomography (iOCT) as a tool for intraoperative imaging, diagnostics and surgery monitoring in newborn and infants with anterior segment anomalies and corneal opacities.
Retrospective case series of four newborn and infants with anterior segment anomalies (2 children with congenital corneal opacities, 1 child with congenital cataract and one with iridocorneal synechiae), who underwent examinations under general anesthesia, using a commercially available 840nm OCT, mounted to an operating microscope (iOCT; OptoMedical Technologies, Luebeck, Germany). Mean age was 6 years (range: 6 month - 14 years).
Anterior segments could be completely visualized in the intraoperative set up using iOCT under general anesthesia including cornea, anterior chamber angle, iris and lens despite presence of corneal opacities. iOCT was a helpful tool to detect corneal, iridal and lens-anomalies in these newborn and infants, who were not accessible to normal OCT-diagnostics without general anesthesia. Moreover iOCT enabled intraoperative decision making to perform anterior segment surgery (e.g. phototherapeutic keratectomy or lamellar keratectomy) in patients with corneal opacities. Furthermore, depth of tissue ablation could precisely be monitored during anterior lamellar keratectomy.
Intraoperative Optical Coherence Tomography (iOCT) closes the gap of imaging diagnostics observed in newborns and infants, who have to be examined under general anesthesia and are not accessible to “routine” advanced imaging techniques so far. Furthermore iOCT proved to be a helpful tool for online monitoring of anterior segment surgery in newborn and infant children.
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