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Swept source high resolution anterior segment optical coherence tomography (OCT) imaging after Descemet's membrane endothelial keratoplasty (DMEK)

Poster Details

First Author: V.Liarakos GREECE

Co Author(s):    M. Arvanitis   A. Maniateas   M. Douvali   M. Rodriguez   M. Satue        

Abstract Details

Purpose:

To evaluate the clinical contribution of Swept-source anterior segment optical coherence tomography (OCT) in early postoperative follow up after Descemet membrane endothelial keratoplasty (DMEK).

Setting:

Eye Day Clinic, Athens, Greece (www.eyeclinic.com.gr)

Methods:

We included 7 successive DMEK surgeries in this prospective study. High resolution images were captured preoperatively and postoperatively with 2 different Swept-source high resolution OCT devices, one with a laser wavelength of 1310nm (CASIA SS 1000, TOMEY) and one with a laser wavelength of 840nm (AVANTI RTVUE XR, Optovue). Scanning speed was 30000 and 70000 A-scans/second, respectively. Central and peripheral corneal changes were evaluated at 1 and 3 days and at 1, 2 and 4 weeks after DMEK.

Results:

The CASIA scanned successfully the whole cornea (limbus to limbus) before and after DMEK (128 radial scans in 2 seconds) providing images of the peripheral edges of the DMEK graft. We noticed early partial peripheral detachments in 2 cases with spontaneous reattachment in the first 2 weeks and persistent partial peripheral detachment in one case. Preoperative corneal mapping was not feasible with the AVANTI, due to corneal irregularities and edema. Corneal pachymetry and epithelial map (central 6mm) was feasible only postoperatively. The primary edematous epithelium was restored within 3-15 days after DMEK, without having removed the epithelium intraoperatively.

Conclusions:

Modern Swept-source anterior segment OCT technology may provide extremely detailed and valuable clinical information. CASIA SS 1000 is superior in terms of quick scan of the entire cornea (limbus to limbus) providing visualization of the peripheral edges of the DMEK graft. This is important for decision making for a possible rebubbling. AVANTI RTVUE XR provides only central detailed corneal imaging with additional epithelial mapping, which is useful for evaluating restoration process after DMEK.

Financial Disclosure:

NONE

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