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Published in: BMC Ophthalmology 1/2016

Open Access 01-12-2016 | Research article

Visualization of precut DSAEK and pre-stripped DMEK donor corneas by intraoperative optical coherence tomography using the RESCAN 700

Authors: Akira Kobayashi, Hideaki Yokogawa, Natsuko Mori, Kazuhisa Sugiyama

Published in: BMC Ophthalmology | Issue 1/2016

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Abstract

Background

To report the feasibility of intraoperative spectral domain optical coherence tomography (OCT) using the RESCAN 700 for the visualization and evaluation of precut Descemet’s stripping automated endothelial keratoplasty (DSAEK) and prestripped Descemet’s membrane endothelial keratoplasty (DMEK) donor tissue.

Methods

Precut DSAEK (n = 11), prestripped DMEK (n = 4) preserved in a viewing chamber were examined by intraoperative OCT. Wholly intact donor corneas for penetrating keratoplasty (PK) (n = 8) were also examined as controls. The obtained images were analyzed qualitatively for characteristics of each type of donor.

Results

For each type of donor, characteristic images were consistently obtained by intraoperative OCT in both the front and back views through the viewing chamber. In wholly intact donors for PK, appearance of normal corneal curvature and stromal texture with high reflectivity of epithelium and endothelium cell layers were clearly visualized. In precut DSAEK donors, precut lines were characteristically visualized in addition to the intact donor cornea images. In prestripped DMEK donors, identical OCT images to the intact donor cornea were noted when observed from the anterior surface. However, peripheral partial detachments of Descemet’s membrane were characteristically observed in all prestripped DMEK donors when viewed from the back of the viewing chamber.

Conclusion

Rapid visualization and rough evaluation of donor tissues for PK, precut DSAEK and prestripped DMEK donor corneas by intraoperative OCT was consistently possible through the viewing chamber. Therefore, this device may be used as an alternative of AS-OCT when the eyebank does not have their own AS-OCT. Although the peripheral detachment in DMEK donors are quite common and clinically non-problematic in DMEK donor quality and subsequent DMEK surgeries, it may be useful to distinguish between wholly intact PK donors and prestripped DMEK donors, enabling to prevent mix-ups of donors, especially when several different types of keratoplasties are scheduled in a same day in one operating theater.
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Metadata
Title
Visualization of precut DSAEK and pre-stripped DMEK donor corneas by intraoperative optical coherence tomography using the RESCAN 700
Authors
Akira Kobayashi
Hideaki Yokogawa
Natsuko Mori
Kazuhisa Sugiyama
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2016
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-016-0308-z

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