Purchase this article with an account.
Katie Hallahan, Gina Smith, Justis Ehlers, Jeff Goshe; Use of intraoperative Optical Coherence Tomography to evaluate graft-host interface separation in Descemet Stripping Automated Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3083.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare the graft-host interface separation after corneal sweeping and after air fluid exchange using intraoperative spectral domain optical coherence tomography (iOCT) during Descemet Stripping Automated Endothelial Keratoplasty (DSAEK).
DSAEK via the technique described by Terry (Terry MA, et al, Ophthalmology 2008; 115;1179-1186) was performed by a single surgeon (JG) in a case series of 23 eyes in 23 patients. Pathology included Fuchs endothelial dystrophy (n=18), previously failed penetrating keratoplasty (n=2), previously failed DSAEK (n=1), pseudophakic bulbous keratopathy (n=1), and Brown-McLean syndrome (n=1). iOCT was executed after corneal sweeping and after air fluid exchange. Graft-host interface separation was digitally quantified in the axial and transverse dimensions and compared after corneal sweeping and after air fluid exchange using a paired t-test.
Average axial length of the graft-host interface was 34.6 + 28.5 um post-sweep and 59.6 + 92.7 um post-air fluid exchange (p = 0.24). Average transverse length of the graft-host interface was 1.16 + 1.15 mm post-sweep and 1.29 + 1.65 mm post-air fluid exchange (p = 0.62). No visible interface fluid was present in 4 eyes after corneal sweeping and in 5 eyes after air fluid exchange.
Air fluid exchange in DSAEK does not introduce a significant change in graft-host interface separation compared to the separation present after corneal sweeping. iOCT can evaluate the efficacy of surgical techniques in DSAEK by quantifying graft-host interface separation and confirming graft adherence in real-time.
This PDF is available to Subscribers Only