Anterior Segment Optical Coherence Tomography (As-Oct) Imaging Following Supraciliary Miniject Implantation In Open-Angle Glaucoma

To evaluate the MINIject (MJ) position, cleft size, presence and size of supraciliary and suprachoroidal space (SC) on anterior segment optical coherence tomography (AS-OCT).

Swiss Glaucoma Research at Swiss-visio Clinic, Lausanne, Switzerland

MINIject implantation was performed successfully in 29 eyes. The operated eyes were imaged post-operatively at 1 day, 1 week, 1 month, 3 months, and 6 months by AS-OCT (ANTERION, Heidelberg Engineering, Germany) according to a pre-defined protocol. Implant depth (ID) which determines the position of the MJ with reference to Schwalbe’s line and implant position (IP) in the anterior chamber, were graded from 1 to 3. Cleft width (CW) and presence and extent of posterior suprachoroidal fluid (SCF) were graded from 0 to 4. The cleft size (CS) was further measured in clock hours and angle degrees.

Mean baseline IOP of 23.1±8.4 mmHg and 15±2.0 at 6 months. Post-operatively, the mean grade for SCF was 2.9±0.9 on day 1 and 1.6±0.5 at 6 months, and 2.8±0.4 on day 1 and 3.3±0.9 at 6 months for CW. On average, 3.6±0.5 quadrants displayed SCF at 1 day versus 2.5±1.7 at 6 months. For the ID with respect to Schwalbe’s line, 25% were located anterior to it, 31.3% were found at the same level, and 43.8% were behind it. Furthermore, 18.2%  were directed close to the cornea, 71.7% toward the anterior chamber, and 9.1% close to the iris. The implant’s depth and position did not change at 6 months. The average cleft size was 41.6±3 degrees (1.4 clock hours) on day 1 and decreased to 27.1±4.6 degrees (0.92 clock hours) at 6 months.

AS-OCT is a non-invasive tool to image the supraciliary and suprachoroidal space after MINIject implantation. Establishing a grading system will allow to quantify and further understand the dynamics around SC devices and correlate them with IOP and surgical success.