Correlation between the graft–host junction of penetrating keratoplasty by anterior segment-optical coherence tomography and the magnitude of postoperative astigmatism

Abstract

Purpose:This study aimed to evaluate the alignment pattern of the graft–host junction after penetrating keratoplasty (PK) by anterior segment-optical coherence tomography (AS-OCT) and to correlate this pattern with the magnitude of postoperative astigmatism.Methods:This retrospective observational study was carried out on forty patients who underwent PK from February 2013 to August 2014. AS-OCT was performed, and the graft–host junctions were classified into well-apposed junction, malapposed junction, and equally apposed junction. Mal-apposition is subdivided into gap and protrusion. The correlations between clinical characteristics, wound profiles from the AS-OCT, and the magnitude of postoperative astigmatism by Sirius camera (Costruzione Strumenti Oftalmici [CSO], Florence, Italy (CSO, Sirius), were analyzed.Results:Graft–host junctions from forty patients were analyzed; 18 eyes had well-apposed junctions, ten eyes had malapposed junctions, and 12 had equally apposed junctions. The mean cylinder was −9.44 ± −4.00D in well-apposed group, −13.40 ± −5.01D in malapposed group, and −4.67 ± −0.94D in equally apposed group. Alignment pattern of the graft–host junction correlated significantly with the magnitude of astigmatism (P = 0.034). Preoperative corneal diseases did not have an effect on the magnitude of astigmatism (P = 0.123).Conclusion:The alignment pattern of the graft–host junction by AS-OCT can explain the postoperative astigmatism after PK where it correlates significantly with the magnitude of astigmatism.

Individualized Corneal Patching for Treatment of Corneal Trauma Combined with Tissue Defects

“…To successfully fulfill the individually designed surgery, AS-OCT, a nontouch technique, could be used to demonstrate the structure of corneal wound preoperatively and analyze the profile at the graft-host junction postoperatively [ 15 , 16 ]. The precise apposition at the graft-host junction is an important target of keratoplasty and a prognostic factor affecting visual outcomes [ 17 ].…”

Managing Post-Keratoplasty Astigmatism: High-Tech vs. Low-Tech Imaging Techniques for Guiding Suture Manipulation

“…Slit lamp examination is likely to miss internal junction misapposition because, typically, it is not detected on the front surface [58,59]. With special attention to the internal alignment of the graft-host junction, AS-OCT has been utilized to analyse the configuration of the graft-host junction and assess wound healing [58][59][60][61]. Primary diagnosis and grafthost oversizing can affect the misalignment of the graft-host junction [58][59][60].…”

Associação de implante de segmentos de anéis corneanos intraestromais com ceratectomia fotorrefrativa para tratamento de alto astigmatismo após ceratoplastia penetrante

“…101 Enxertos ovais podem resultar de uma trepanação inclinada e estão fortemente relacionados a astigmatismo. 102 Disparidade de espessura na junção doador-receptor altera os vetores de força, gerando astigmatismo. Quaisquer fatores que interfiram nesse processo podem gerar cicatrização heterogênea e astigmatismo, em especial deiscência de ferida.…”