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Intraoperative OCT in lamellar keratoplasty

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First Author: S.Demyanchenko RUSSIA

Co Author(s):    A. Tereschenko                    

Abstract Details

Purpose:

The most useful function of intraoperative OCT is represented when performing such interventions as Descemet’s membrane endothelial keratoplasty (DMEK), Descemet’s stripping endothelial femtokeratoplasty with an ultra-thin graft (UT fs-DSEK) and deep anterior lamellar keratoplasty (DALK), however, this issue is currently available in the literature not enough. Purpose is to analyze the own results of the use of intraoperative OCT during Descemet’s membrane endothelial keratoplasty, Descemet’s stripping endothelial femtokeratoplasty with an ultra-thin graft and deep anterior lamellar keratoplasty.

Setting:

The S. Fyodorov Eye Microsurgery Federal State Institution Kaluga branch

Methods:

Keratoplasty was performed using the intraoperative microscope Hi-R Neo 900 (Haag-Streit Surgical, Germany) with integrated OST 3 generation. There were 15 DALK operations for keratoconus grade 3, 45 DMEK operations for bullous keratopathy after previously performed phacoemulsification with IOL implantation, and 25 UT fs-DSEK operations for bullous keratopathy after previously performed vitrectomy with phacoemulsification and IOL implantation.

Results:

During the DALK operation, the formation of «big bubble» was noted in 14 cases. Thanks to the iOCT function, the depth of the channel for pneumodissection was monitored and the location of the cannula inside the channel was monitored during the formation of a «big bubble». When performing DMEK, the iOCT function allowed visualization of the endothelial graft roll in the anterior chamber of the eye in all 45 cases. When performing UT fs-DSEK, it was noted that iOCT allows differentiating the endothelial and stromal surface of the ultra-thin graft located in the anterior chamber of the patient's eye.

Conclusions:

In all cases of lamellar keratoplasty performed using iOCT, surgical interventions were successful with a reduction in the time of the surgical aid. IOCT using the Hi-R NEO 900A N/R system with an integrated optical coherence tomograph iOCT 3 generation has proved to be an indispensable tool in corneal surgery, providing a higher level of predictability of the course of surgical treatment. The advantages of using iOCT to the maximum extent manifest themselves in violation of the transparency of the cornea, when the capabilities of standard optical microscopy do not allow you to visualize ultra-thin structures of the cornea.

Financial Disclosure:

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