Ultra-High Resolution Optical Coherence Tomography Findings In Patients With Fuchs Endothelial Corneal Dystrophy Undergoing Endothelial Keratoplasty
Published 2022 - 40th Congress of the ESCRS
Reference: FPT06.04 | Type: Free paper | DOI: 10.82333/535x-qk74
Authors: Andreas Schlatter* 1 , Nino Hirnschall 2 , Kristina Zeller 3 , Doreen Schmidl 4 , Leopold Schmetterer 5 , Gerhard Garhöfer 4 , Oliver Findl 3 , René Marcel Werkmeister 6
1Department of Clinical Pharmacology,Medical University of Vienna,Vienna,Austria;Vienna Institute for Research in Ocular Surgery (VIROS), a Karl-Landsteiner-Institute,Hanusch Hospital,Vienna,Austria, 2Department of Ophthalmology and Optometry,Kepler University Hospital GmbH, Johannes Kepler Universtiy Linz,Linz,Austria, 3Vienna Institute for Research in Ocular Surgery (VIROS), a Karl-Landsteiner-Institute,Hanusch Hospital,Vienna,Austria, 4Department of Clinical Pharmacology,Medical University of Vienna,Vienna,Austria, 5Singapore Eye Research Institute,Singapore National Eye Centre,Singapore,Singapore;Department of Clinical Pharmacology,Medical University of Vienna,Vienna,Austria;Nanyang Technological University,Singapore,Singapore;Ophthalmology and Visual Sciences Academic Clinical Program,Duke-NUS Medical School,Singapore,Singapore;SERI-NTU Advanced Ocular Engineering (STANCE),Singapore,Singapore;Institute of Molecular and Clinical Ophthalmology,Basel,Switzerland;Center for Medical Physics and Biomedical Engineering (CMPBE),Medical University of Vienna,Vienna,Austria, 6Center for Medical Physics and Biomedical Engineering (CMPBE),Medical University of Vienna,Vienna,Austria
Purpose
To employ ultra-high resolution optical coherence tomography (UHR-OCT) for corneal imaging in patients with Fuchs endothelial corneal dystrophy (FECD) that underwent either Descemet membrane endothelial keratoplasty (DMEK) or Descemet stripping automated endothelial keratoplasty (DSAEK) at different pre-defined time points.
Setting
Department of Clinical Pharmacology, Medical University of Vienna, Vienna
Center for Medical Physics and Biomedical Engineering (CMPBE), Medical University of Vienna, Vienna
Vienna Institute for Research in Ocular Surgery (VIROS), a Karl-Landsteiner-Institute, Hanusch Hospital, Vienna
Methods
Patients with FECD that were scheduled for DMEK or DSAEK surgery were included in this prospective study. Study visits were carried out before surgery and 1 or 2 days, 1 week, 1 month, 6 months, and 12 months after. Besides UHR-OCT, clinical routine investigations were performed in the study eye. The presented UHR-OCT scans were obtained by a custom-built UHR-OCT device, with axial and lateral resolutions of 1.3 µm and 20 µm, respectively, and a scanning rate of 140.000 A-scans per second. Besides the assessment of graft attachment, morphological characteristics of the different corneal layers were imaged. Additionally, a comparison with a commercial anterior segment OCT device (MS-39®, CSO Italia) was performed.
Results
In total, 5 cases (3 DMEK, 2 DSAEK) will be presented and correlated to clinical results. In the obtained UHR-OCT scans, postoperative superficial punctate keratitis, variations of reflectivity within the corneal stroma and a hyporeflective band within the Descemet’s membrane-endothelium complex in a patient with a history of Herpes keratitis were observed. Graft and host Descemet’s-membrane-endothelium complexes were compared in the peripheral graft-host transition zone. Furthermore, the "F"-mark was visualized postoperatively by en face projection of the volumetric OCT data in a patient that underwent DMEK surgery.
Conclusions
While commercial AS-OCT devices are well applicable for the detection of graft detachments, UHR-OCT provided more detailed imaging of corneal morphology and can, therefore, offer complementary data regarding perioperative morphological alterations in patients with FECD.