TY - JOUR
T1 - Intraoperative optical coherence tomography in descemet stripping automated endothelial keratoplasty
T2 - pilot experiences
AU - Steverink, Jasper G.
AU - Wisse, Robert P L
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Purpose: To assess the added value of intraoperative optical coherence tomography (iOCT) in evaluating graft adhesion and graft interface in patients undergoing descemet’s stripping automated endothelial keratoplasty (DSAEK). Methods: This is a prospective single-center case series comprising 8 eyes of 8 patients consecutively scheduled for DSAEK surgery. iOCT imaging was performed after insertion of the graft, after pressurizing the eye, and at the end of surgery (three images per surgery). At each stage of surgery, corneal thickness and the widest gap between the recipient and the graft (i.e., maximal interface width) were measured using an image processing tool. Follow-up measurements were taken at 1 day, 3 and 6 months, post-operatively. Results: Imaging was performed in 21 of 24 scheduled imaging intervals, and required little to no additional surgical time. At the end of surgery, iOCT showed persisting interfaces in six cases. One case showed a full graft detachment necessitating surgical intervention. Conclusion: Real-time iOCT is a safe, efficient, and useful tool in assessing graft adherence in DSAEK surgery. With adequate analysis software, iOCT has the potential to be a paradigm-shifting development in posterior lamellar surgery and could aid the clinician in further lowering the rates of graft dislocation after DSAEK.
AB - Purpose: To assess the added value of intraoperative optical coherence tomography (iOCT) in evaluating graft adhesion and graft interface in patients undergoing descemet’s stripping automated endothelial keratoplasty (DSAEK). Methods: This is a prospective single-center case series comprising 8 eyes of 8 patients consecutively scheduled for DSAEK surgery. iOCT imaging was performed after insertion of the graft, after pressurizing the eye, and at the end of surgery (three images per surgery). At each stage of surgery, corneal thickness and the widest gap between the recipient and the graft (i.e., maximal interface width) were measured using an image processing tool. Follow-up measurements were taken at 1 day, 3 and 6 months, post-operatively. Results: Imaging was performed in 21 of 24 scheduled imaging intervals, and required little to no additional surgical time. At the end of surgery, iOCT showed persisting interfaces in six cases. One case showed a full graft detachment necessitating surgical intervention. Conclusion: Real-time iOCT is a safe, efficient, and useful tool in assessing graft adherence in DSAEK surgery. With adequate analysis software, iOCT has the potential to be a paradigm-shifting development in posterior lamellar surgery and could aid the clinician in further lowering the rates of graft dislocation after DSAEK.
KW - DSAEK
KW - Intraoperative optical coherence tomography
KW - Live OCT
KW - Posterior lamellar keratoplasty
KW - RESCAN
UR - http://www.scopus.com/inward/record.url?scp=84988646126&partnerID=8YFLogxK
U2 - 10.1007/s10792-016-0338-9
DO - 10.1007/s10792-016-0338-9
M3 - Article
C2 - 27655298
AN - SCOPUS:84988646126
SN - 0165-5701
VL - 37
SP - 939
EP - 944
JO - International Ophthalmology
JF - International Ophthalmology
IS - 4
ER -