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Corneal morphology assessed by ultra-high resolution optical coherence tomography in patients with Fuchs endothelial corneal dystrophy undergoing endothelial keratoplasty

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First Author: A.Schlatter AUSTRIA

Co Author(s):    R. Werkmeister   N. Hirnschall   D. Schmidl   G. Garhöfer   O. Findl        

Abstract Details

Purpose:

To assess corneal morphology with a novel ultra-high resolution optical coherence tomography (UHR-OCT) device with an axial and lateral resolution of 1.3 µm and 20 µm, respectively, and a scanning rate of 140.000 A-scans/second (s) in patients with Fuchs endothelial corneal dystrophy (FECD) undergoing Descemet membrane endothelial keratoplasty (DMEK) or Descemet stripping automated endothelial keratoplasty (DSAEK) at different pre-defined time points.

Setting:

Vienna Institute for Research in Ocular Surgery (VIROS), a Karl-Landsteiner-Institute, Hanusch Hospital, Vienna; Center for Medical Physics and Biomedical Engineering (CMPBE), Medical University Vienna, Vienna; Department of Clinical Pharmacology, Medical University Vienna, Vienna

Methods:

Patients with FECD that were scheduled either for DMEK or DSAEK surgery were included in this study. Study visits were carried out before surgery and 1/2 days, 1 week, 1 month, 6 months, and 12 months after surgery. Besides UHR-OCT, best-corrected visual acuity (BCVA), slit-lamp examination, endothelial cell count (CellChek® SL), intra-ocular pressure and central corneal thickness was evaluated. Additionally, routinely performed anterior segment (AS) OCT scans obtained by MS-39® (3.6 µm [axial resolution] x 35 µm [transversal resolution], 50.000 A-scans/s) and AS module of Spectralis® HRA+OCT (3.9 µm x 14 µm, 40.000 A-scans/s) were compared to UHR-OCT.

Results:

Twelve eyes of twelve FECD patients have been included into the study. Preoperatively, mean BCVA was 64.6 ETDRS letters (standard deviation [SD]: ± 18.2; range: 15-80; n=11), mean IOP was 12.3 mmHg (SD: ± 1.6; range: 10-14; n=10), and mean central corneal thickness (CCT) was 600.4 µm (SD: ± 80.3; range: 473–766; n=9). Endothelial cell count was evaluable only in one eye. Alongside detailed assessment of graft attachment after surgery, UHR-OCT revealed variations of scattering patterns in posterior stromal tissue. Additional preliminary UHR-OCT findings will be presented at 25th ESCRS winter meeting.

Conclusions:

UHR-OCT allows much more detailed imaging compared to commercially available OCT systems. This could be beneficial for documenting endothelial pathologies, as well as post-operative evaluation.

Financial Disclosure:

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