Anterior Segment OCT: Application to Improve Graft Selection for Corneal Transplantation

Seitz, Berthold; Asi, Fatema; Mäurer, Stephanie; Hamon, Loïc; Quintin, Adrien; Langenbucher, Achim

doi:10.1007/978-3-030-53374-8_11

Cited by 8 publications

(8 citation statements)

References 51 publications

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“…In the last few years, new techniques have been developed to improve the quality of corneas in the eye bank. Anterior segment optical coherence tomographs (AS-OCT) represent an interesting option for the analysis of corneoscleral discs (CD) in sterile conditions, including pachymetry and evaluation of front and back surface curvature (Seitz et al 2021 ). However, existing AS-OCT instruments are not developed for such applications of ex-vivo imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Being part of a university corneal transplantation center with on-site eye bank, we use the same AS-OCT that is used daily in the framework of our consultations. As a standard procedure, tomographic images of all CD are performed preoperatively at our Department of Ophthalmology since 2018 (Seitz et al 2021 ). This option—available in the majority of large ophthalmology centers—does not require any additional costs.…”

Section: Discussionmentioning

confidence: 99%

“…If the peripheral measurements are generally of minor importance, they may enable the detection of specific abnormalities such as marginal pellucid degeneration or an ulcer, for example. Secondly, this self-programmed MATLAB software contains others functionalities which require 3D modeling, such as a keratometric analysis (steep and flat anterior and posterior radii of curvature) with detection of curvature anomalies (Damian et al 2017 ) and an automated detection of corneal opacities (stromal scars, corneal flap after laser in situ keratomileusis (LASIK), corneal dystrophies, …) (Seitz et al 2021 ). This information is of great importance for eye banks, considering that a cornea with curvature anomaly or stromal densification can be used—for example—for DMEK, if the endothelial cell count (ECC) is sufficient.…”

Section: Discussionmentioning

confidence: 99%

“…The possibility of qualifying CD in eye banks using topo- or tomographs had already been considered since 1999 (Terry et al 1999 ) but has made significant progress in recent years. Nowadays, donor tomography can be used in clinical routine as a screening method prior to keratoplasty (Seitz et al 2021 ; Quintin et al 2021a ) and has already been used, amongst others, to tailor out the best timepoint for changing from MI to MII before penetrating keratoplasty (Wolf et al 2009 ; Hamon et al 2021 ) to improve the IOL power calculation in classical triple procedure (Quintin et al 2021b ) and to “harmonize” the donor and recipient tomography (Mäurer et al 2020). However, the corneal tomographs were not developed for this purpose and other challenges when measuring CD under sterile conditions are the optical distortions of the culture container and image deterioration with culture media.…”

Section: Introductionmentioning

confidence: 99%

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Reliability and efficiency of corneal thickness measurements using sterile donor tomography in the eye bank

et al. 2021

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To evaluate the reliability and efficiency of sterile pachymetric measurements of donor corneas based on tomographic data using two different methods: a “manual” and a “(semi-)automated” method. Twenty-five (25) donor corneas (50%) stored in MI and 25 (50%) in MII were imaged 5 times consecutively using an anterior segment OCT (AS-OCT). The central corneal thickness (CCT) was measured both with the manual measurement tool of the AS-OCT (= CCTm) and with a MATLAB self-programmed software allowing (semi-)automated analysis (= CCTa). We analyzed the reliability of CCTm and CCTa using Cronbach´s alpha (α) and Wilcoxon signed-Rank Test. Concerning CCTm, 68 measurements (54.4%) in MI and 46 (36.8%) in MII presented distortions in the imaged 3D-volumes and were discarded. Concerning CCTa, 5 (4%) in MI and 1 (0.8%) in MII were not analyzable. The mean (± SD) CCTm was 1129 ± 6.8 in MI and 820 ± 5.1 µm in MII. The mean CCTa was 1149 ± 2.7 and 811 ± 2.4 µm, respectively. Both methods showed a high reliability with a Cronbach´s α for CCTm of 1.0 (MI/MII) and for CCTa of 0.99 (MI) and 1.0 (MII). Nevertheless, the mean SD of the 5 measurements was significantly higher for CCTm compared to CCTa in MI (p = 0.03), but not in MII (p = 0.92). Sterile donor tomography proves to be highly reliable for assessment of CCT with both methods. However, due to frequent distortions regarding the manual method, the (semi-)automated method is more efficient and should be preferred.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reliability and efficiency of corneal thickness measurements using sterile donor tomography in the eye bank

et al. 2021

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“…During cultivation, further examinations were performed, such as slitlamp biomicroscopy, endothelial cell count, microbiological testing, and sterile donor tomography. 3,4 The tissue was approved for transplantation in the absence of contraindications. 5 Triple-PKP à chaud was performed under general anesthesia with controlled arterial hypotension.…”

Section: Surgical Procedures and Postoperative Managementmentioning

confidence: 99%