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M. M. Bosch, C. Kaufmann, M. N. Menke, S. L. Watson, P. B. Knecht; Use of Intraoperative Fourier-Domain Anterior Segment OCT During DSAEK. Invest. Ophthalmol. Vis. Sci. 2010;51(13):766.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate intraoperative use of a handheld Fourier-Domain optical coherence tomography (OCT) during Descemet’s stripping automated endothelial keratoplasty (DSAEK) to assess the donor-host interface.
A prospective, observational case series. Six consecutively scheduled patients undergoing DSAEK surgery were included. Intraoperative OCT scans of the cornea were performed after 1) insertion of the donor disc, 2) instillation of air in the anterior chamber beneath the disc; 3) vent incisions in the host cornea in each quadrant; 4) following air-fluid exchange at the end of operation; and 5) the first postoperative day. The central 4mm of the cornea was scanned. The broadest width of the interface between donor and host cornea was measured using the onboard software of the handheld OCT.
Images of the interface between the host and donor were obtained in all patients at each imaging session. No complications resulted from the intraoperative or post-operative use of the handheld OCT. In 2 patients there was a decrease in the width of the interface fluid after each surgical step documented by OCT scans. At the end of their operation, no fluid was left. In 2 further patients, fluid disappeared after the stab incisions and did not reappear during the further course of the surgery. In the last 2 patients the detectable separation between the host and donor remained unchanged throughout the surgery. All patients had no detectable fluid within the interface 1 day after surgery. No graft dislocations occurred.
OCT can be used to assess the host-donor interface in lamellar corneal transplantation surgery. Improved understanding of the host-donor interface may have implications for further development of the instrumentation and technique.
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