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"Mouse Sign" on Optical Coherence Tomography of Detached Endothelial Graft Indicates Graft Inversion
Dhivya Ashok Kumar1, Shana Sood1, Amar Agarwal1
1Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.
Journal of Ophthalmic & Vision Research
|August 10, 2018
Summary
The "mouse sign" on optical coherence tomography (OCT) after pre-Descemet endothelial keratoplasty (PDEK) indicates an inverted graft. This finding predicts failed rebubbling, necessitating graft exchange.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Diagnostic Imaging
Background:
- Pre-Descemet's endothelial keratoplasty (PDEK) is a surgical technique for endothelial dysfunction.
- Graft detachment is a potential postoperative complication following PDEK.
- Early identification of graft malposition is crucial for successful visual recovery.
Observation:
- A distinct 'mouse sign' morphology was observed in detached PDEK grafts via optical coherence tomography (OCT).
- This configuration involved a thick, convex scroll of the detached graft.
- The detachment occurred within two weeks postoperatively in three observed cases.
Findings:
- The 'mouse sign' on OCT imaging suggests graft inversion.
- This specific OCT finding predicted the failure of rebubbling procedures in all observed cases.
- All patients with the 'mouse sign' ultimately required graft exchange.
Implications:
- The 'mouse sign' serves as a critical indicator of graft inversion after PDEK.
- It predicts a poor prognosis for conservative management such as rebubbling.
- Prompt recognition of the 'mouse sign' can guide surgical decision-making towards graft exchange, optimizing patient outcomes.