Real-time imaging of transscleral diode laser cyclophotocoagulation by optical coherence tomography

Purpose To present optical coherence tomography (OCT) for real-time imaging of cyclophotocoagulation effects. Methods In a pilot study, real-time transscleral OCT images were generated during diode laser cyclophotocoagulation in four eyes of four patients suffering from uncontrolled glaucoma using a specially designed contact applicator containing the OCT fiber, a focussing fiber optic and the fiber of the diode laser. Results When the contact system was used, two layers could be differentiated: a superficial thick hyperreflective complex representing conjunctiva, Tenon’s capsule, episclera and sclera, and a thinner hyporeflective layer representing the ciliary body. During cyclophotocoagulation, real-time OCT showed a clear and sudden thickening of the ciliary body in the treated area. Conclusion This new OCT device represents a first step towards visual, real-time imaging of cyclophotocoagulation. After further adaptation of the delivery system, further trials are needed to correlate OCT findings with aqueous production and intraocular pressure. The authors have no commercial or financial interest in the study.