Long-Term Monitoring Of Corneal Grafts Via Anterior Segment Optical Coherence Tomography Pachymetry Maps

To assess the efficacy of Anterior Segment Optical Coherence Tomography (AS-OCT) in long-term monitoring of corneal grafts and its integration into telemedicine for early detection and management of graft rejection or failure.

This prospective cohort study was conducted at a tertiary ophthalmology clinic of a State hospital in Cyprus. Data collection was carried out from seventy-four patients (93 eyes) who underwent corneal transplantation from October 2021 to December 2023, with a follow-up period of at least 6 months.

Prospective study of 74 patients (93 eyes) who underwent corneal transplantation between October 2021 and December 2023 and with a minimum follow-up of 6 months. Serial AS-OCT pachymetry maps and cross-sectional scans were performed at fixed post-operative intervals and the findings were correlated with  clinical signs of graft rejection or failure on slit-lamp examination. All patients were enrolled in a telemedicine protocol for remote AS-OCT monitoring starting at 1 week post-operatively.

AS-OCT demonstrated high diagnostic accuracy with a specificity of 97.62% and sensitivity of 88.89% in detecting graft rejection or failure, through precise measurements of corneal and graft thickness. The mean central corneal thickness increase in cases leading to graft rejection or failure was 82.67 ± 21.45 μm. Three representative cases are described in detail. The utility of AS-OCT in remote monitoring reduced the need for frequent in-person visits, optimizing resource allocation and patient convenience.

Serial AS-OCT imaging is an invaluable tool for corneal graft surveillance, providing objective and quantitative assessments of graft performance even without clinical signs and symptoms. Its accurate, real-time data makes it an excellent tool for remote monitoring, transforming post-operative care and significantly improving patient outcomes.