Use of intraoperative anterior segment optical coherence tomography during a Descemet's stripping with automated endothelial keratoplasty surgery
First Author: M.Vicente Altabás SPAIN
Co Author(s): M. Romero Sanz L. Arias Campo J. Sánchez Monroy M. Puzo Bayod A. Mateo Orobia A. Sánchez Pérez
Showing how Intraoperative Anterior Segment Optical Coherence Tomography (iOCT-SA) is able to guide the development and help to resolve complications during a Descemet Stripping with Automated Endothelial Keratoplasty (DSAEK) surgery.
The use of iAS-OCT is establishing as a safe and effective resource to help corneal surgeon. In fact, sometimes is essential when taking a key decision is needed.
It is analysed a DSAEK surgery guided with iAS-OCT and how it plays a crucial role there. After making the suitable incisions and removing Descemet layer, the graft was inserted in anterior camera, placing it in contact with posterior stroma of receptor thanks to an injection of air in anterior camera. Due to the use of iAS-OCT, the surgeon realized that there was not a good adherence between donor and receptor cornea, because of an irregular trepanation of donor stroma. The graft was removed and remodelled. Then, it was relocated and there was a perfect adherence between tissues.
We can appreciate how iAS-OCT was capable to detect this complication during the live procedure and that allows solving it in that moment. In this way, it allows to reduce reinterventions and permits obtaining better results in these kinds of surgeries
The use of iAS-OCT in corneal surgeries constitutes an emergent and promising tool that allow for obtaining high precision images. The iAS-OCT is able to detect incipient stromal scars and guide the folding out and orientation of the graft, even in corneas with reduced transparency. This tool gives support to the surgeon and improves the security of the procedure.