PURPOSE: To evaluate the predictive value of early anterior segment optical coherence tomography (AS-OCT) on graft adherence or detachment after Descemet's membrane endothelial keratoplasty (DMEK). DESIGN: Retrospective study of prospectively collected data at a tertiary referral center. PARTICIPANTS: A total of 87 eyes of 87 patients of a consecutive series of 142 DMEK surgeries. METHODS: Anterior segment OCT was performed within the first hour after DMEK and at 1 week, 1 month, 3 months, and 6 months, and for each time interval detachments were classified as "none," ≤ 1/3 detachment, >1/3 detachment of the total graft surface area, or "complete" detachment. Throughout the study, no rebubbling procedures were performed. MAIN OUTCOME MEASURES: Graft adherence at various postoperative time intervals. RESULTS: One-hour AS-OCT scans were more accurate at predicting the final 6-month graft adherence status than those at 1 week or 1 month. Grafts showing complete attachment or <1/3 detachment at 1 hour remained stable or improved in 73% of the cases at 1 week, 82% at 1 month, 86% at 3 months, and 90% at 6 months. All grafts attached at 1 week remained attached at 6 months. Graft detachments of >1/3 at 1 hour showed reattachment at 6 months in 25% of the cases, whereas 67.5% of the cases showed a persistent detachment of >1/3 at 6 months and 12.5% showed a complete detachment. CONCLUSIONS: The 1-hour AS-OCT scan showed the best predictive value on 6-month graft adherence status. The combined information of the 1-hour and 1-week AS-OCT scans may facilitate decision making about surgical reintervention after DMEK.
PURPOSE: To evaluate the predictive value of early anterior segment optical coherence tomography (AS-OCT) on graft adherence or detachment after Descemet's membrane endothelial keratoplasty (DMEK). DESIGN: Retrospective study of prospectively collected data at a tertiary referral center. PARTICIPANTS: A total of 87 eyes of 87 patients of a consecutive series of 142 DMEK surgeries. METHODS: Anterior segment OCT was performed within the first hour after DMEK and at 1 week, 1 month, 3 months, and 6 months, and for each time interval detachments were classified as "none," ≤ 1/3 detachment, >1/3 detachment of the total graft surface area, or "complete" detachment. Throughout the study, no rebubbling procedures were performed. MAIN OUTCOME MEASURES: Graft adherence at various postoperative time intervals. RESULTS: One-hour AS-OCT scans were more accurate at predicting the final 6-month graft adherence status than those at 1 week or 1 month. Grafts showing complete attachment or <1/3 detachment at 1 hour remained stable or improved in 73% of the cases at 1 week, 82% at 1 month, 86% at 3 months, and 90% at 6 months. All grafts attached at 1 week remained attached at 6 months. Graft detachments of >1/3 at 1 hour showed reattachment at 6 months in 25% of the cases, whereas 67.5% of the cases showed a persistent detachment of >1/3 at 6 months and 12.5% showed a complete detachment. CONCLUSIONS: The 1-hour AS-OCT scan showed the best predictive value on 6-month graft adherence status. The combined information of the 1-hour and 1-week AS-OCT scans may facilitate decision making about surgical reintervention after DMEK.
Authors: Kyeong Hwan Kim; Marius A Tijunelis; Yunshu Zhou; David C Musch; Christopher T Hood; Bradford L Tannen; Shahzad I Mian Journal: Cornea Date: 2020-10 Impact factor: 2.651
Authors: Stephan Ong Tone; Viridiana Kocaba; Myriam Böhm; Adam Wylegala; Tomas L White; Ula V Jurkunas Journal: Prog Retin Eye Res Date: 2020-05-08 Impact factor: 21.198
Authors: Philipp Steven; Carolin Le Blanc; Eva Lankenau; Marc Krug; Stefan Oelckers; Ludwig M Heindl; Uta Gehlsen; Gereon Huettmann; Claus Cursiefen Journal: Br J Ophthalmol Date: 2014-07 Impact factor: 4.638