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Optical coherence tomography of the anterior segment in secondary glaucoma with corneal opacity after penetrating keratoplasty
  1. Farnaz Memarzadeh,
  2. Yan Li,
  3. Brian A Francis,
  4. Ronald E Smith,
  5. Julie Gutmark,
  6. David Huang
  1. Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  1. Correspondence to: Dr David Huang Doheny Eye Institute, 1450 San Pablo Street, DEI5702, Los Angeles, CA 90033, USA; dhuang{at}


Aim: To evaluate secondary glaucoma after penetrating keratoplasty with anterior-segment optical coherence tomography (OCT).

Design: Case series.

Methods: Four eyes of four patients with corneal opacity and increased intraocular pressure (IOP) were evaluated using high-speed (2000 axial scans/s) OCT at 1.3 μm wavelength. Cross-sectional images of the anterior segment were analysed to assess the cause of increase in pressure.

Results: Slit-lamp evaluation of the anterior chamber in all cases was limited by corneal opacity. The OCT imaging allowed visualisation of anterior-segment structures behind the opaque corneas. Using OCT, iris–intraocular lens adhesion and pupillary block were identified as the probable reasons for the increased IOP in one case. Peripheral anterior synechiae and angle closure were identified in the three remaining cases. In two cases, we found that the tip of the aqueous drainage tube was blocked by peripheral anterior synechiae.

Conclusions: OCT is similar to ultrasound in that it allows visualisation through opaque corneas. However, OCT has an advantage in that it requires neither contact nor immersion. It is a valuable tool for evaluating the depth of the anterior chamber angle and the causes of secondary angle closure.

  • IOL, intraocular lens
  • IOP, intraocular pressure
  • OCT, optical coherence tomography
  • PAS, peripheral anterior synechiae
  • UBM, ultrasound biomicroscopy

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  • Published Online First 13 September 2006

  • NIH R24 EY 13015 grant from National Eye Institute, Bethesda, Maryland, USA; research equipment and grant from Carl Zeiss Meditec, Dublin, California, USA; an unrestricted grant from Research to Prevent Blindness, New York, New York, USA.

  • Competing interests: DH receives royalty from OCT patents licensed to Carl Zeiss Meditec, Dublin, California, USA. D H and Y L receive research grant support from Carl Zeiss Meditec.