Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
Cornea. 2011 Dec;30(12):1369-75. doi: 10.1097/ICO.0b013e31820d86bd.
To evaluate the efficacy of anterior segment optical coherence tomography (OCT), Scheimpflug imaging, and slit-lamp biomicroscopy in the early detection of a (partial) graft detachment after Descemet membrane endothelial keratoplasty (DMEK).
Anterior segment OCT, Scheimpflug imaging, and slit-lamp biomicroscopy were performed in 120 eyes of 110 patients after DMEK.
Seventy-eight eyes showed a normal corneal clearance, and the attached Descemet grafts could not be identified with any of the imaging techniques. Forty-two eyes showed persistent stromal edema in the first postoperative month. In transplanted corneas that (partially) did not clear in the early postoperative period, OCT had an added diagnostic value in 36% of cases (15 of 42 eyes) in visualizing whether the graft was detached and, in particular, to discriminate between a "flat" graft detachment and delayed corneal clearance. In contrast, in the presence of corneal edema, Scheimpflug imaging did not provide more information than slit-lamp biomicroscopy in the detection of a graft detachment.
Anterior segment OCT may be an effective tool in the detection of an early graft detachment after DMEK, to determine if secondary surgical intervention is indicated or is to be avoided.
评估眼前段光学相干断层扫描（OCT）、Scheimpflug 成像和裂隙灯生物显微镜在早期发现去内皮角膜内皮移植（DMEK）后部分（不完全）移植物脱离的效果。
对 110 例 120 只眼行 DMEK 术后的眼前段 OCT、Scheimpflug 成像和裂隙灯生物显微镜检查。
78 只眼角膜透明，任何一种成像技术均无法识别附着的Descemet 移植物。42 只眼在术后第一个月仍存在持续性基质水肿。在早期未完全清除的移植眼中，OCT 在 36%（42 眼中的 15 只）的病例中对移植物是否脱离具有附加诊断价值，特别是可以区分“扁平”移植物脱离和延迟角膜清除。相比之下，在存在角膜水肿的情况下，Scheimpflug 成像在检测移植物脱离方面并未比裂隙灯生物显微镜提供更多信息。
眼前段 OCT 可能是 DMEK 后早期移植物脱离检测的有效工具，以确定是否需要进行二次手术干预或避免手术。
