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Clinical science
Optimising deep anterior lamellar keratoplasty (DALK) using intraoperative online optical coherence tomography (iOCT)
  1. Philipp Steven1,
  2. Carolin Le Blanc1,
  3. Eva Lankenau2,
  4. Marc Krug2,
  5. Stefan Oelckers3,
  6. Ludwig M Heindl1,
  7. Uta Gehlsen1,
  8. Gereon Huettmann4,
  9. Claus Cursiefen1
  1. 1Department of Ophthalmology, University of Cologne, Cologne, Germany
  2. 2OptoMedical Technologies GmbH, Luebeck, Germany
  3. 3Moeller-Wedel GmbH, Wedel, Germany
  4. 4Institute of Biomedical Optics, University of Luebeck, Luebeck, Germany
  1. Correspondence to Dr Philipp Steven, Department of Ophthalmology, University Hospital of Cologne, Kerpener Strasse 62, Cologne 50937, Germany; philipp.steven{at}uk-koeln.de

Abstract

Background/aims To describe the use of intraoperative online optical coherence tomography (iOCT) for improving deep anterior lamellar keratoplasty (DALK) surgery.

Methods Retrospective case series of 6 eyes of 6 male patients with keratokonus, corneal dystrophy or herpetic stromal scars undergoing DALK were investigated using intraoperative optical coherence tomography and postsurgical image/video analysis. Main outcome measures were: visibility of surgical steps, especially, assessment of placement depth of injection needle, preparation of bare Descemet's membrane and drainage of interface fluid.

Results iOCT enables real-time visualisation of all surgical steps of DALK procedure in all patients. Placement of air injection needle above Descemet's membrane was reliably monitored as was presence of bare Descemet's membrane and potential interface fluid.

Conclusions iOCT assists with visualisation of injection needle placement and with assessment of bare Descemet's membrane as well as interface fluid during the DALK procedure. Overall iOCT may be a helpful device that supports surgeons in all steps of DALK procedure.

  • Cornea
  • Imaging
  • Treatment Surgery

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/bjophthalmol-2013-304585

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