Purpose:
To evaluate corneal arc–scan ultrasound imagingas a technique for differentiating and measuring corneal (hostand donor) thicknesses after DSAEK.
Methods:
Very high frequencycorneal ultrasound imaging (Artemis, UltraLink LLC, St. Petersburg,FL) was performed at 4 postoperative visits in 3 patients enrolledin a prospective IRB–approved study of DSAEK with donorlenticles procured with a 300–um LSK microkeratome (Moria,Antony, FR). Six meridional arc scans separated by 30 degreesof rotation were obtained, and the ArtPro software package wasused with manual interface seeding to reconstruct three–dimensionalmaps of total corneal, epithelial, host and donor thicknessprofiles.
Results:
Ultrasound images demonstrated the anteriorand posterior corneal borders and clearly demarcated the graft–hostinterface. An example of a single meridian arc scan is providedin the accompanying figure. Central thickness values obtainedfrom each map are tabulated below. Host stromal thickness inpatients measured between 2 weeks and 6 months after DSAEK rangedfrom 461 to 505 um. Corresponding central thickness values indonor lenticles ranged from 133 to 253 um. Donor and host thicknessesin Patient 1 were only slightly thinner at 6 months than at2 weeks.
Conclusions:
Arc–scan very high–frequencyultrasound analysis distinguishes donor and recipient thicknessesafter DSAEK. Graft and host deturgescence may be quantifiedover time, and could be correlated with vision, refraction,cell counts and graft survival.
Keywords: imaging/image analysis: clinical • cornea: clinical science