Saad Alain, Guilbert Emmanuel, Grise-Dulac Alice, Sabatier Patrick, Gatinel Damien
*Anterior Segment and Refractive Surgery Department, Rothschild Foundation, Paris, France; †Center for Expertise and Research in Optics for Clinicians (CEROC); and ‡French Eye Bank, Paris, France.
Cornea. 2015 Jul;34(7):802-7. doi: 10.1097/ICO.0000000000000462.
To describe the utility of a new intraoperative optical coherence tomographer (OCT) to evaluate endothelio-Descemet graft orientation during Descemet membrane endothelial keratoplasty (DMEK) procedures.
Prospective, observational, and single-center pilot case series including 14 eyes of 14 patients consecutively scheduled for DMEK surgery. After injecting the graft into the anterior chamber, the graft orientation was assessed with the help of anterior segment OCT. The surgical time and unfolding time were measured. The postoperative measurements included best-corrected visual acuity, central pachymetry, and specular microscopy at 1 month.
Using the OCT images, it was possible to evaluate the graft orientation in all cases. The mean unfolding time was 6.1 ± 3.0 minutes, the mean best-corrected visual acuity was 0.3 ± 0.3 logarithm of the minimum angle of resolution, the mean decrease in central pachymetry was 213 ± 177 μm, and the mean central endothelial cell count was 1906 ± 319 cells per square millimeter.
Live intraoperative OCT is useful to visualize and assess graft orientation in DMEK surgery. It enables faster graft positioning with less graft manipulation in the presence of severe corneal edema.
描述一种新型术中光学相干断层扫描仪（OCT）在Descemet膜内皮角膜移植术（DMEK）过程中评估内皮-Descemet植片方向的效用。
前瞻性、观察性单中心试点病例系列，纳入14例连续计划行DMEK手术患者的14只眼。将植片注入前房后，借助眼前节OCT评估植片方向。测量手术时间和展开时间。术后测量包括1个月时的最佳矫正视力、中央角膜厚度测量和角膜内皮镜检查。
利用OCT图像，所有病例均能评估植片方向。平均展开时间为6.1±3.0分钟，平均最佳矫正视力为0.3±0.3最小分辨角对数，中央角膜厚度平均减少213±177μm，中央内皮细胞平均计数为每平方毫米1906±319个细胞。
术中实时OCT有助于在DMEK手术中可视化和评估植片方向。在存在严重角膜水肿的情况下，它能使植片定位更快，减少植片操作。
