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International Ophthalmology

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Open Access 01-10-2020 | Keratoplasty | Original Paper

Indications for intraoperative anterior segment optical coherence tomography in corneal surgery

Authors: Stefan J. Lang, Sonja Heinzelmann, Daniel Böhringer, Thomas Reinhard, Philip Maier

Published in: International Ophthalmology | Issue 10/2020

Abstract

Purpose

Recently, intraoperative optical coherence tomography (iOCT) has evolved in the field of ophthalmic surgery. So far, the use of iOCT was mainly focused to lamellar keratoplasty, especially deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK). The aim of this study was to report our experiences with iOCT to introduce new possibilities of this application.

Methods

We used iOCT in 18 patients who underwent the following surgeries: DALK, DMEK, penetrating keratoplasty, autologous limbal transplantation, transscleral suture fixation of a posterior chamber lens, pannus removal on corneal surface and newborn investigation in Peters’ anomaly. We obtained qualitative video data for all procedures.

Results

With the iOCT, the cannula placement during DALK preparation of the recipient cornea and bubble formation could be visualized to improve the success rate of the big bubble injection. In DMEK, the iOCT enables the visualization of Descemet’s membrane removal in the recipient and graft orientation as well as better control of graft attachment. The iOCT enables intraoperative visualization of the graft–host interface during penetrating keratoplasty. During autologous limbal transplantation, transscleral suture fixation of a posterior chamber lens and removal of corneal surface pannus the iOCT is capable of showing the thickness of lamellar preparations to avoid penetrations and to save healthy recipient’s tissue.

Conclusion

The iOCT is a helpful device for intraoperative anterior segment imaging not only for DALK and DMEK. It is also beneficial in penetrating keratoplasty and every other form of lamellar preparation during corneoscleral surgery.

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Title: Indications for intraoperative anterior segment optical coherence tomography in corneal surgery
Authors: Stefan J. Lang
Sonja Heinzelmann
Daniel Böhringer
Thomas Reinhard
Philip Maier
Publication date: 01-10-2020
Publisher: Springer Netherlands
Keyword: Keratoplasty
Published in: International Ophthalmology / Issue 10/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-020-01442-0

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Springer Medicine

Indications for intraoperative anterior segment optical coherence tomography in corneal surgery

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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