Original articlePredictive Value of Optical Coherence Tomography in Graft Attachment after Descemet's Membrane Endothelial Keratoplasty
Section snippets
Materials and Methods
From a larger series of 142 consecutive eyes that underwent DMEK (cases 235–376), 87 eyes of 87 patients had “complete” AS-OCT measurements available at all time intervals after surgery (i.e., 1 hour, 1 week, 1 month, 3 months, and 6 months) and were included in our study (Fig 1). Surgeries were performed between August 2010 and July 2011. No reinjection of air was performed throughout this study. The indication for surgery was Fuchs' endothelial dystrophy (n = 81) or bullous keratopathy (n =
Results
Because the 1-hour, 1-week, and 1-month postoperative time intervals after DMEK may be critical for the decision of whether to await the clinical course or to plan a reintervention, the predictive values for graft attachment status at 6 months were evaluated for AS-OCT images of these postoperative time intervals.
Discussion
Graft detachment has been recognized as the main complication after endothelial keratoplasty surgery.4, 14, 15 With current techniques evolving from DSEK/DSAEK to DMEK, the thinner grafts in the latter technique may be more susceptible to incomplete adherence to the recipient posterior stroma, potentially affecting the final visual outcome. As such, it is of interest to elaborate on how to avoid graft detachments and how to manage them.4 This study was undertaken to further refine the clinical
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Manuscript no. 2012-636.
Financial Disclosure(s): The author(s) have made the following disclosure(s): Dr. Melles is a consultant for D.O.R.C. International/Dutch Ophthalmic USA.
Funding: Dr. Liarakos received the 2011 Annual Scholarship from the Hellenic Society of Intraocular Implants and Refractive Surgery.