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M. E. J. Van Velthoven, C. Biallosterski, F. D. Verbraak, I. J. E. van der Meulen, G. R. J. Melles, C. P. Nieuwendaal; Thickness Measurement of the Posterior Lamella After Posterior Lamellar Keratoplasty, With the Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3885. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the posterior lamellar donor thickness measured with the Visante anterior segment OCT in patients with Fuchs’ endothelial dystrophy after posterior lamellar keratoplasty (PLK).
Patients following PLK, with manually dissected donor lamellae, were measured with the new anterior segment OCT (Visante OCT, Carl Zeiss Meditec). Four cross-sectional scans were made in a radial pattern, 45° apart. Thickness measurements were done centrally, and at 1.5 and 3 mm at both sides from the center. Thickness measurements were correlated with postoperative best-corrected visual acuity (BCVA in Snellen).
Seventeen eyes of 15 patients were included in the study. Median (range) BCVA was 0.25 (0.01-0.40) pre-operative, and 0.5 (0.32-0.80) postoperatively. Median follow-up time was 15.5 months (range 5-32 months). Fifteen eyes showed improvement of visual acuity after PLK, no patients had loss of vision. Median (range) lamellar thickness (at 180°) was 117 (64-183) micron in the center, and increased significantly towards the periphery (142 (77-334) micron, 130 (59-267) micron, 134 (92-260 micron) and 178 (93-309 micron) at -3, -1.5, 1.5 and 3 mm from the center respectively; Figure 1A). A trend was seen showing better postoperative BCVA with thinner central posterior lamellae (Figure 1B). Thickening of the lamellae towards the periphery had no influence on BCVA.
This study shows that PLK, with manually dissected lamellae, in patients with decompensated Fuchs’ endothelial dystrophy is a successful procedure. OCT measurements of the lamellar thickness showed significant variance in central thickness compared to peripheral thickness, but this had no influence on postoperative BCVA. A trend was seen towards better postoperative BCVA with a thinner center of the lamellae.
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