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Intraoperative OCT-Assisted DMEK: 14 Consecutive Cases.

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Summary

Intraoperative optical coherence tomographer (OCT) effectively assesses graft orientation during Descemet membrane endothelial keratoplasty (DMEK) surgery. This technology aids in quicker graft positioning and reduced manipulation, especially in cases with significant corneal edema.

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Area of Science:

  • Ophthalmology
  • Surgical Technology
  • Corneal Surgery

Background:

  • Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure to restore endothelial function in the cornea.
  • Accurate graft orientation is crucial for successful DMEK outcomes.
  • Intraoperative visualization tools can potentially improve surgical efficiency and outcomes.

Purpose of the Study:

  • To evaluate the utility of a novel intraoperative optical coherence tomographer (OCT) for assessing graft orientation during DMEK.
  • To determine if OCT can aid in graft positioning and reduce surgical manipulation.

Main Methods:

  • A prospective, observational, single-center pilot study involving 14 patients undergoing DMEK.
  • Anterior segment OCT was used to assess graft orientation after injection into the anterior chamber.
  • Surgical time, graft unfolding time, best-corrected visual acuity, pachymetry, and endothelial cell count were measured.

Main Results:

  • OCT successfully evaluated graft orientation in all 14 cases.
  • The mean graft unfolding time was 6.1 ± 3.0 minutes.
  • Postoperative outcomes included a mean best-corrected visual acuity of 0.3 ± 0.3 logMAR and a mean endothelial cell count of 1906 ± 319 cells/mm².

Conclusions:

  • Intraoperative OCT is a valuable tool for visualizing and assessing graft orientation in DMEK.
  • The use of OCT can lead to faster graft positioning and decreased manipulation, particularly beneficial in corneas with severe edema.