Intraoperative optical coherence tomography-guided donor corneal tissue assessment and preparation

Area of Science:

• Ophthalmology
• Medical Imaging
• Corneal Surgery

Background:

• Donor cornea quality is critical for successful keratoplasty.
• Clinical grading has limitations in assessing subtle donor tissue characteristics.
• Intraoperative imaging can potentially enhance donor evaluation.

Purpose of the Study:

• To evaluate intraoperative optical coherence tomography (i-OCT) for donor grading, selection, and preparation in keratoplasty.
• To assess the accuracy of i-OCT compared to clinical grading.
• To determine the utility of i-OCT in different keratoplasty techniques.

Main Methods:

• Seventy-one donor corneas were evaluated using i-OCT after clinical grading.
• Donor preparation for various keratoplasty types was performed under i-OCT guidance.
• Experienced corneal surgeons utilized i-OCT for real-time assessment and tissue manipulation.

Main Results:

• i-OCT grading matched clinical grading in 98.5% of cases.
• Subtle abnormalities like irregular thickness and scars were identified.
• i-OCT facilitated microkeratome selection, manual dissection, and precise needle advancement for different keratoplasty procedures.
• Donor preparation methods (manual vs. automated) showed distinct margin characteristics under i-OCT.

Conclusions:

• Intraoperative optical coherence tomography (i-OCT) provides objective assessment of donor corneas.
• i-OCT can complement clinical evaluation for donor grading, selection, and preparation.
• This technology holds promise for improving outcomes in corneal transplantation.