PT  - JOURNAL ARTICLE
AU  - Philipp Steven
AU  - Carolin Le Blanc
AU  - Eva Lankenau
AU  - Marc Krug
AU  - Stefan Oelckers
AU  - Ludwig M Heindl
AU  - Uta Gehlsen
AU  - Gereon Huettmann
AU  - Claus Cursiefen
TI  - Optimising deep anterior lamellar keratoplasty (DALK) using intraoperative online optical coherence tomography (iOCT)
AID  - 10.1136/bjophthalmol-2013-304585
DP  - 2014 Jul 01
TA  - British Journal of Ophthalmology
PG  - 900--904
VI  - 98
IP  - 7
4099  - http://bjo.bmj.com/content/98/7/900.short
4100  - http://bjo.bmj.com/content/98/7/900.full
SO  - Br J Ophthalmol2014 Jul 01; 98
AB  - 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.