May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Use of Anterior Chamber Optical Coherence Tomography (AC-OCT) Imaging in Descemet’s Stripping With Automated Endothelial Keratoplasty (DSAEK)
Author Affiliations & Notes
  • L. H. Suh
    Cornea and External Diseases, Bascom Palmer Eye Institute, Miami, Florida
  • W. W. Culbertson
    Cornea and External Diseases, Bascom Palmer Eye Institute, Miami, Florida
  • Footnotes
    Commercial Relationships L.H. Suh, None; W.W. Culbertson, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 3871. doi:
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      L. H. Suh, W. W. Culbertson; Use of Anterior Chamber Optical Coherence Tomography (AC-OCT) Imaging in Descemet’s Stripping With Automated Endothelial Keratoplasty (DSAEK). Invest. Ophthalmol. Vis. Sci. 2007;48(13):3871.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To use anterior chamber optical coherence tomography (AC-OCT) for the preoperative and postoperative imaging of corneas undergoing Descemet’s Stripping with Endothelial Keratoplasty (DSEK). In DSEK, a donor corneoscleral button is precut in a lamellar fashion with a microkeratome to create a donor posterior lamellar button containing posterior stroma and endothelium. During DSEK, Descemet’s membrane and endothelium are stripped and replaced with the donor lamellar button. The AC-OCT was used to assess the preoperative cornea, the state of the DSEK button postoperatively, and to assess for any postoperative complications such as detachments and interface abnormalities.

Methods:: The Visante OCT (Carl Zeiss Meditec, Dublin, CA) was used in patients undergoing DSEK. A donor corneoscleral button mounted in an artificial anterior chamber (Moria, Doylestown, PA) with a lamellar plane created by a microkeratome was imaged. Before surgery, the recipient cornea in one patient was imaged to assess preoperative corneal thickness. AC-OCT was also used to assess postoperative states and complications such as graft detachments and interface haze.

Results:: In one patient with pseudophakic bullous keratopathy, the AC-OCT showed thickening of the stroma and epithelial bullae. The AC-OCT imaged the lamellar plane created by a microkeratome in a donor corneoscleral button mounted on an anterior chamber. The AC-OCT also showed the normal apposition of the DSEK lamellar button to the recipient stroma. The lamellar button was meniscus-shaped with tapered flanges. Progressive deturgescence of a cornea after uncomplicated DSEK was also imaged. Finally, postoperative complications such as donor button detachment and the presence of fluid, epithelial ingrowth, blood, and Descemet’s membrane in the recipient-donor interface was assessed with AC-OCT.

Conclusions:: There are many applications of AC-OCT in DSEK surgery. The preoperative thickness can be gauged by the AC-OCT and compared to postoperative thicknesses. The plane created by the microkeratome in the donor button preparation can be shown by AC-OCT. Progressive deturgescence of the recipient cornea can be followed. Finally, complications of DSEK surgery, such as detachment and presence of interface material can be easily imaged with AC-OCT.

Keywords: imaging/image analysis: clinical • cornea: clinical science 
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