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Updated: Oct 11, 2025
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
i-PDEK: Microscope-integrated OCT-assisted pre-Descemet endothelial keratoplasty
Namrata Sharma1, Chandra Devi, Rinky Agarwal
1From 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).
Microscope-integrated optical coherence tomography (i-OCT) guided pre-Descemet endothelial keratoplasty (PDEK) surgery, improving outcomes for patients with corneal edema. This advanced imaging technology enhanced surgical precision and graft success.
Area of Science:
- Ophthalmology
- Surgical Technology
- Corneal Surgery
Background:
- Pseudophakic corneal edema presents a significant challenge in visual rehabilitation.
- Pre-Descemet endothelial keratoplasty (PDEK) is an advanced endothelial keratoplasty technique.
- The precise execution of PDEK steps can be technically demanding.
Purpose of the Study:
- To evaluate the utility of microscope-integrated optical coherence tomography (i-OCT) in guiding pre-Descemet endothelial keratoplasty (PDEK).
- To assess the impact of i-OCT guidance on surgical steps and outcomes in PDEK.
Main Methods:
- Four patients with pseudophakic corneal edema underwent PDEK guided by i-OCT.
- i-OCT was utilized for real-time visualization and guidance during critical surgical maneuvers.
- Key surgical steps assessed included donor preparation, epithelial debridement, wound planning, Descemet membrane manipulation, and graft placement.
Main Results:
- i-OCT facilitated successful type 1 big bubble formation and precise surgical wound placement.
- Real-time i-OCT imaging allowed for accurate donor orientation and interface assessment.
- Postoperative visual acuity improved significantly, and grafts remained clear and attached at 6 months with acceptable endothelial cell loss.
Conclusions:
- Microscope-integrated optical coherence tomography (i-OCT) is a valuable tool for enhancing surgical precision in pre-Descemet endothelial keratoplasty (PDEK).
- i-OCT guidance contributes to successful graft outcomes and improved visual acuity in patients with pseudophakic corneal edema.
