Abstract
Purpose. To examine the graft-host interface during Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery with optical coherence tomography (OCT). Design. Prospective, interventional case series. Patients and Methods. Eight patients who underwent a DSAEK were included. A handheld OCT was used intraoperatively to examine the presence of interface fluid between the host cornea and the graft. Results. In 3 patients, no interface fluid was detected between the host cornea and the graft after the graft was attached by air injection. In 4 patients, interface fluid was detected after the graft was attached by air injection. The remaining interface fluid was drained through corneal stab incisions. One patient required a second surgery because the first surgery failed due to persistence of the interface fluid. All patients showed a complete attachment of the graft at one month after the DSAEK surgery. Conclusion. A handheld OCT is useful to detect the interface fluid between the host cornea and the graft during a DSAEK.
Highlights
Penetrating keratoplasty has mainly been performed for the treatment of bullous keratopathy and other diseases with corneal endothelial dysfunction
We prospectively examined the graft-host interface during a Descemet’s stripping automated endothelial keratoplasty (DSAEK) with a handheld optical coherence tomography (OCT)
During DSAEK in patient 1, no interface fluid was detected between the host cornea and the graft by a handheld OCT after the injection of air (Figure 2)
Summary
Penetrating keratoplasty has mainly been performed for the treatment of bullous keratopathy and other diseases with corneal endothelial dysfunction. DSAEK is more advantageous for the recovery of visual acuity than penetrating keratoplasty, its complications include postoperative graft detachment and graft dislocation [1,2,3,4,5,6,7]. The rates of these complications vary between 4% and 50% [1,2,3,4,5,6,7]. Two of these studies reported that anterior segment optical coherence tomography (OCT) is useful to assess the status of the graft-host interface [8, 10]
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