Anterior Segment Ocular Coherence Tomography SLOCT Following DSAEK

1
Anterior Segment Ocular Coherence Tomography
(SL-OCT) Following DSAEK

• Noga Harizman MD
• David C. Ritterband MD
• Eric K. Chiu MD
• Boris Ovodenko MD
• Syril Dorairaj MD
• Jeffrey Liebmann MD
• Robert Ritch MD
• Richard S. Koplin MD
• John A. Seedor MD

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Background

• SL-OCT (Heidelberg Engineering, GmBH, Dossenheim
  , Germany) uses a diode laser infrared 1310 nm
  light source and has a maximum scanning
  resolution of 15 µm laterally and 9 µm axially.
• The SL-OCT is non-contact and provides rapid and
  objective means of obtaining qualitative and
  quantitative information in the routine clinical
  setting.
• SL- OCT is useful in imaging eyes in the
  immediate postoperative period when contact with
  the eye may not be advisable, and in measuring
  features that may be distorted by contact.

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Purpose

• To determine the utility of Slit-lamp-adapted
  anterior segment OCT (SL-OCT) in imaging DSAEK
  (Descemets Stripping Automated Endothelial
  Keratoplasty) buttons for signs of interface
  fluid or other pathology in the early post-op
  period.

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Methods

• 20 eyes of 20 patients who underwent DSAEK for
  chronic corneal edema underwent anterior segment
  SL-OCT prior to surgery and on two or more
  subsequent post-op visits.

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Results

• 15/20 eyes had attached DSAEK buttons with no
  central interface fluid on both SL-OCT and slit
  lamp examination (post-op days 2-7).

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Results

• 5 of 20 eyes had slit lamp and SL-OCT evidence of
  interface fluid at post-op day 1-7 and were
  taken back to the operating room for
  re-positioning.

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Results

• SL-OCT detected Descemet remnants
• in the interface which were later surgically
  removed.

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Results

• SL-OCT demonstrated subtle interface fluid
  pockets unrecognized on slit-lamp examination.

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Conclusion

• SL-OCT is a useful adjunctive imaging device to
  demonstrate anatomical relationships.
• SL-OCT can assist clinical decisions based on
  slit lamp exam.