From the Cataract, Cornea and Refractive Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India (Sharma, Devi, R. Agarwal, Bafna); Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India (A. Agarwal).
J Cataract Refract Surg. 2021 Dec 1;47(12):e44-e48. doi: 10.1097/j.jcrs.0000000000000603.
Four patients with pseudophakic corneal edema were subjected to pre-Descemet endothelial keratoplasty (PDEK) under the direct guidance of microscope-integrated optical coherence tomography (i-OCT). i-OCT facilitated successful type 1 big bubble formation during donor preparation, debridement of the hypertrophic epithelium, planning and placement of surgical wounds, descemetorrhexis with removal of remnant Descemet membrane tags, and identification of correct donor orientation and interface details. It was also possible to discern the stability of intraocular lens, flat iris configuration, adequate stromal hydration, and wound apposition on i-OCT. Preoperative visual acuity was counting fingers (50%), 0.78 logMAR (25%), and 1.48 logMAR (25%), whereas postoperative visual acuity was 0.6 logMAR (50%) and 0.3 logMAR (50%). At 6-months of follow-up, all grafts were clear and well attached, the mean central corneal thickness, graft size, graft thickness, and endothelial cell loss were 557.25 ± 13.45 μm, 7.75 ± 0.20 mm, 25.5 ± 2.64 μm, and 21.6 ± 0.02%, respectively. To conclude, i-OCT helped during various surgical steps of PDEK.
四位假性囊膜性角膜水肿患者在显微镜集成光学相干断层扫描（i-OCT）的直接引导下接受了前房深基质角膜内皮移植术（PDEK）。i-OCT 有助于在供体准备、肥厚上皮清创、手术切口规划和放置、去除残余的后弹力膜标签的后弹力膜切开术以及识别正确的供体方向和界面细节期间成功形成 1 型大泡。还可以在 i-OCT 上辨别人工晶状体的稳定性、扁平虹膜形态、足够的基质水化和伤口贴合。术前视力为指数（50%）、0.78 logMAR（25%）和 1.48 logMAR（25%），而术后视力为 0.6 logMAR（50%）和 0.3 logMAR（50%）。在 6 个月的随访中，所有移植物均清晰且附着良好，平均中央角膜厚度、移植物大小、移植物厚度和内皮细胞丢失分别为 557.25 ± 13.45μm、7.75 ± 0.20mm、25.5 ± 2.64μm 和 21.6 ± 0.02%。总之，i-OCT 有助于 PDEK 的各个手术步骤。
