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Abstract：
OBJECTIVE: To assess the added value of intraoperative optical coherence tomography (iOCT) in evaluating graft adhesion and graft interface in patients undergoing descemet\'s stripping automated endothelial keratoplasty (DSAEK).
METHODS: This is a prospective single-center case series comprising 8 eyes of 8 patients consecutively scheduled for DSAEK surgery. iOCT imaging was performed after insertion of the graft, after pressurizing the eye, and at the end of surgery (three images per surgery). At each stage of surgery, corneal thickness and the widest gap between the recipient and the graft (i.e., maximal interface width) were measured using an image processing tool. Follow-up measurements were taken at 1 day, 3 and 6 months, post-operatively.
RESULTS: Imaging was performed in 21 of 24 scheduled imaging intervals, and required little to no additional surgical time. At the end of surgery, iOCT showed persisting interfaces in six cases. One case showed a full graft detachment necessitating surgical intervention.
CONCLUSIONS: Real-time iOCT is a safe, efficient, and useful tool in assessing graft adherence in DSAEK surgery. With adequate analysis software, iOCT has the potential to be a paradigm-shifting development in posterior lamellar surgery and could aid the clinician in further lowering the rates of graft dislocation after DSAEK.
METHODS: This is a prospective single-center case series comprising 8 eyes of 8 patients consecutively scheduled for DSAEK surgery. iOCT imaging was performed after insertion of the graft, after pressurizing the eye, and at the end of surgery (three images per surgery). At each stage of surgery, corneal thickness and the widest gap between the recipient and the graft (i.e., maximal interface width) were measured using an image processing tool. Follow-up measurements were taken at 1 day, 3 and 6 months, post-operatively.
RESULTS: Imaging was performed in 21 of 24 scheduled imaging intervals, and required little to no additional surgical time. At the end of surgery, iOCT showed persisting interfaces in six cases. One case showed a full graft detachment necessitating surgical intervention.
CONCLUSIONS: Real-time iOCT is a safe, efficient, and useful tool in assessing graft adherence in DSAEK surgery. With adequate analysis software, iOCT has the potential to be a paradigm-shifting development in posterior lamellar surgery and could aid the clinician in further lowering the rates of graft dislocation after DSAEK.
摘要：
目的：评估术中光学相干断层扫描（iOCT）在评估下段剥离自动内皮角膜移植术（DSAEK）患者的移植物粘连和移植物界面中的附加价值。
方法：这是一个前瞻性单中心病例系列，包括8例连续计划进行DSAEK手术的患者的8只眼。插入移植物后进行iOCT成像,给眼睛加压后，在手术结束时（每个手术三张图像）。在手术的每个阶段,角膜厚度和接受者和移植物之间的最宽间隙(即，最大界面宽度）使用图像处理工具进行测量。在1天进行后续测量，3和6个月，术后。
结果：在24个预定的成像间隔中有21个进行了成像，并且几乎不需要额外的手术时间。手术结束时,iOCT显示6例存在界面。一例显示完全的移植物脱离，需要手术干预。
结论：实时iOCT是一种安全的，高效,和评估DSAEK手术中移植物粘附性的有用工具。有足够的分析软件，iOCT有可能成为后板层手术的范式转变发展,并可帮助临床医生进一步降低DSAEK术后移植物脱位的发生率。
方法：这是一个前瞻性单中心病例系列，包括8例连续计划进行DSAEK手术的患者的8只眼。插入移植物后进行iOCT成像,给眼睛加压后，在手术结束时（每个手术三张图像）。在手术的每个阶段,角膜厚度和接受者和移植物之间的最宽间隙(即，最大界面宽度）使用图像处理工具进行测量。在1天进行后续测量，3和6个月，术后。
结果：在24个预定的成像间隔中有21个进行了成像，并且几乎不需要额外的手术时间。手术结束时,iOCT显示6例存在界面。一例显示完全的移植物脱离，需要手术干预。
结论：实时iOCT是一种安全的，高效,和评估DSAEK手术中移植物粘附性的有用工具。有足够的分析软件，iOCT有可能成为后板层手术的范式转变发展,并可帮助临床医生进一步降低DSAEK术后移植物脱位的发生率。
