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Michael Savetsky, Gina Smith, Siya Huo, Jeffrey Goshe, Justis Ehlers, Sunil Srivastava, William Dupps; Intraoperative OCT Quantification of Residual Interface Fluid in DSAEK. Invest. Ophthalmol. Vis. Sci. 2012;53(14):31.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate whether Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) graft adherence is affected by residual central clefts of interface fluid left at the end of surgery.
A retrospective analysis of 17 DSAEK cases in 17 patients was performed in which Fourier-domain anterior segment OCT was performed intraoperatively. The images taken at the end of surgery were reviewed, and the residual central interface fluid clefts were quantified, using the calipers integrated in the OCT software. The maximal area of fluidic separation was measured in each case. A successful outcome was defined as 100% adherence of the DSAEK graft at day 1 and day 7, with no further manipulation of the graft needed.
Anterior segment OCT successfully ascertained the presence of interface fluid and allowed for quantitative and qualitative analysis of DSAEK graft-host apposition. The measured residual central interface fluid values ranged from 12µm to 50µm. All grafts were 100% attached at day 1 and day 7.
Central cleft interface fluid separations of up to 50µm seem to have no effect on postoperative graft adherence. Larger studies are needed to assess the value of interface fluid separation as a predictor of postoperative graft non-adherence.
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