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Mark Welch, Michael Banitt, Audina Berrocal, Victor Perez; Keratoprosthesis Imaging Using Anterior Segment Optical Coherence Tomography to Detect Graft Host Defects in the Clinic and in the Operating Room. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3465.
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Anterior segment optical coherence tomography (AS-OCT) was used to diagnose subclinical defects in the graft host junction of patients with keratoprostheses.
Noncomparative observational case series: two patients with questionable thinning of the donor corneal tissue were imaged with AS-OCT and determined to have abnormal gaps between the donor tissue and the keratoprosthesis. Tissue thinning was also observed.
The AS-OCT allows for imaging of the abnormal position of a keratoprosthesis. The first case was a seidel negative adult who was imaged in the clinic and determined to have thinning of the donor tissue which required replacement of the keratoprosthesis. The second case was a child in the operating room undergoing an exam under anesthesia (EUA). A non-rhegmatogenous retinal detachment was found with chorioretinal folds. After repair of the retinal detachment, an AS-OCT was performed and a large gap was noted between the keratoprosthesis and the donor tissue of this seidel negative patient. This image led to the appropriate replacement of the keratoprosthesis.
High resolution AS-OCT images provide non-contact, cross-sectional images of a keratoprosthesis and can detect whether the prosthesis and donor tissue are in appropriate position. The images can also detect donor tissue thinning. This is helpful, because thinning of donor tissue can be subclinical. Depending on the device used, images can be obtained with upright positioning in the clinic or with supine positioning in the operating room. These images assist with clinical decisions. It may also be helpful to obtain AS-OCT images on all pediatric patients with a keratoprosthesis at every EUA.
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