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Philipp Steven, Carolin Le Blanc, Sebastian Siebelmann, Ludwig Heindl, Claus Cursiefen; Comparison of time-domain with spectral-domain OCT for detection of graft detachments following DMEK. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3084.
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Descemet membrane endothelial keratoplasty (DMEK) has recently been introduced to restore corneal transparency in patients with corneal endothelial diseases by selectively replacing diseased endothelium. The main post-operative complication is partial or complete detachment of the graft often requiring re-bubbling. It is so far however unclear, if every detachment has to be treated by re-bubbling or when spontaneous re-attachment can be awaited. To detect graft detachment optical coherence tomography (OCT) has been shown to be superior to slitlamp microscopy. This case series compares a time-domain with a spectral-domain OCT device for the detection of partial graft detachment following DMEK.
Data from 150 consecutive patients undergoing DMEK surgery at the Department of Ophthalmology, University of Cologne were retrospectively analyzed for patients with partial graft detachment that were monitored using both time-domain OCT (SL-OCT, Heidelberg Engineering, Heidelberg, Germany) and spectral-domain OCT (Spectralis, Heidelberg Engineering, Heidelberg, Germany).
Twenty patients (10 female, 10 male) demonstrated a post-operative partial graft detachment that was imaged using both OCT devices. From these patients 6 cases were monitored at two, one patient at three time points. Overall, spectral-domain OCT provided better visibility of even slight graft detachments. In follow-up cases, spectral-domain OCT provided better visualization of changes in graft detachment than time-domain OCT. In x/y patients a graft detachment could be detected in spectral-domain OCT, which was not visible in time-domain OCT.
Spectral-domain OCT provides better visibility of graft detachment following DMEK surgery than time-domain OCT. In particular, slight detachments are better or only visualized using spectral-domain OCT. To investigate Descemet membrane attachment and detachment after DMEK spectral-domain OCT provides more accurate information.
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