Intraoperative optical coherence tomography in glaucoma surgery with Ex-PRESS® implant.

IntroductionTo present the correct placement of the Ex-PRESS® implant in the anterior chamber with the intraoperative optical coherence tomography (i-OCT) scan. To the best of our knowledge, this is the first publication to report the use of i-OCT during an Ex-PRESS® glaucoma implant procedure.Case reportWe report the case of a phakic, 48 year-old South American male with bilateral advanced pigmentary glaucoma. Our patient was being treated with dorzolamide-timolol eyedrops twice daily and bimatoprost eyedrops once daily in both eyes. Glaucomatous damage in his left eye had progressed and it was then decided to perform filtering surgery in our patient´s left eye, using a P-50 Ex-PRESS® shunt and two Ologen® collagen matrix implants. As our patient was phakic, special care was taken to avoid contact with the lens. The correct placement of both subscleral devices was confirmed with the OPMI LUMERA® 700 microscope, an i-OCT device. i-OCT scans as well as a video recording were performed throughout the surgical procedure.ConclusionI-Oct can help surgeons to locate the correct placement of implants in cases such as corneal opacification or gerontoxon. This instrument is helpful in the training of ophthalmologists. I-OCT can help surgeons to locate the correct placement of implants in cases with media opacity (such as corneal opacification or gerontoxon) or in phakic patients, where it is important to avoid lens contact. This instrument is helpful in the training of ophthalmologists.