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Real time anterior segment optical coherence tomography: a guiding tool during DMEK surgery

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Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 10:04

Venue: Boulevard B

First Author: : F.Arnalich-Montiel SPAIN

Co Author(s): :    B. Lumbreras-Fernández              

Abstract Details


To describe the use of real time anterior segment optical coherence tomography (AS-OCT) during Descemet Membrane Endothelial Keratoplasty (DMEK).


Institutional practice, university hospital.


At Hospital Ramón y Cajal we performed in vivo intraoperative AS-OCT using a prototype model of OCT attached to the operating microscope by Zeiss (Germany) to three DMEK cases.


In all three cases, OCT images were able to assess Descemet Membrane (DM) roll orientation after injection of the roll into the anterior chamber. In two cases the graft was inverted so maneuvers were done to flip the graft, and correct orientation was assessed in vivo while performing this maneuvers. Correct unrolling of the graft was guided using the OCT except in one case in which there was a very tight roll and an anterior chamber fibrous reaction that did not allowed appropriate attachment of the DM. The OCT helped to assess the orientation and configuration of the DM roll, guided the correct unrolling adhesion of the graft, and identified the situation that compromised the success of the surgery.


Intraoperative in vivo AS-OCT attached to the operating microscope obtained good-quality images of the cornea during DMEK and proved useful in guiding DMEK surgery step by step.

Financial Interest:


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