Abstract
Purpose: This study aimed to evaluate the impact of keratoplasty on the in vivo anatomical structures in the Schlemm’s canal (SC) of nonglaucomatous subjects using Fourier-domain optical coherence tomography (FD-OCT).Methods: Sixty-six nonglaucomatous eyes that underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), or triple surgery were enrolled in this prospective, comparative, observational study. The SC imaging was performed using FD-OCT before and after surgery in both the nasal and temporal quadrants. Patient demographics, SC parameters [e.g., cross-sectional area (CSA), meridional diameter of SC (MSC), sagittal diameter of SC (SSC), and circumference (CCF)], and the correlations between the variation of SC parameters and intraocular pressure (IOP) were analyzed.Results: The mean age of all subjects was 40.27 ± 18.97 years. Among all cases, the nasal, temporal, and mean MSC significantly decreased on the first day after surgery and then increased at 1 week (p = 0.04, 0.017, and 0.01, respectively). Temporal CSA (tCSA), temporal MSC (tMSC), and temporal circumference (tCCF) after PK (p = 0.017, 0.020, and 0.018, respectively) and nasal MSC (nMSC) after DALK (p = 0.025) decreased significantly on the first day after surgery. The shift in mean IOP was significantly correlated with the changes in tMSC (r = 0.341, p = 0.003) and CCF (r = 0.207, p = 0.048).Conclusion: SC had significant in vivo morphological changes in the early period after keratoplasty in nonglaucomatous eyes, accompanied with elevation of IOP. Early intervention might be necessary to prevent secondary glaucoma early after keratoplasty.
Highlights
Since the first description of the technique in 1994, anterior segment optical coherence tomography (AS-OCT) has become increasingly important in clinical practice (Izatt et al, 1994; Ang et al, 2018)
We aimed to investigate the morphological alterations of the s canal (SC) in the immediate and early periods after keratoplasties and to explore their correlations with changes in intraocular pressure (IOP) in nonglaucomatous eyes
Due to the small sample size, data in the triple surgery group were excluded from merged statistics (Table 2)
Summary
Since the first description of the technique in 1994, anterior segment optical coherence tomography (AS-OCT) has become increasingly important in clinical practice (Izatt et al, 1994; Ang et al, 2018). Fourier-domain OCT (FD-OCT) has the advantage of high scanning speed and image quality for a wide range of clinical applications (Mayer et al, 2010; Told et al, 2016; Kreuz et al, 2018; Napoli et al, 2020). The anterior segment CASIA SS-1000 OCT (Tomey Corp., Nagoya, Japan) is a Fourier-domain, sweptsource designed OCT that is reported to be suitable for studying the anatomical structures of aqueous outflow system, including Schlemm’s canal (SC). It uses a light source with a wavelength of 1,310 nm and has a high scanning speed of 30,000 A-scans per second and 256 B-scans over the scanning area. The scanning area is as high as 16 × 16 mm (horizontal and vertical) with a depth of 6 mm (Kagemann et al, 2010; Hong et al, 2013; Angmo et al, 2016; Qi et al, 2020)
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