Stromal Bed Thickness Measurement During Laser in Situ Keratomileusis Using Intraoperative Optical Coherence Tomography

Ye, Cong; Yu, Marco; Jhanji, Vishal

doi:10.1097/ico.0000000000000345

Cited by 11 publications

(9 citation statements)

References 15 publications

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“…A number of studies have described the use of iOCT for a variety of conditions and procedures in both the anterior and posterior segment. 5–17 iOCT in DSAEK has demonstrated the feasibility to identify and quantify interface fluid not readily apparent through the surgical microscope, and it has been used to confirm graft adherence at the end of the operation. 5, 7, 10–12 This is the first and largest study to correlate iOCT measurements of intraoperative fluid dynamics with early graft non-adherence using automated, quantitative values.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Interface Fluid Dynamics and Clinical Outcomes for Intraoperative Optical Coherence Tomography–Assisted Descemet Stripping Automated Endothelial Keratoplasty From the PIONEER Study

Hallahan

Cost

Goshe

et al. 2017

American Journal of Ophthalmology

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Purpose To correlate intraoperative interface fluid dynamics during Descemet stripping automated endothelial keratoplasty (DSAEK) surgery using intraoperative optical coherence tomography (iOCT) in the PIONEER (Prospective Intraoperative and Perioperative Ophthalmic ImagiNg with Optical CohEncE TomogRaphy) study with postoperative outcomes. Design Prospective consecutive, interventional, comparative case series Participants One hundred and seventy-eight eyes of 173 patients undergoing DSAEK from the Cole Eye Institute, Cleveland, USA. Methods Eyes that underwent DSAEK between October 2011 and March 2014 from the PIONEER intraoperative and perioperative OCT study were included. An automated interface fluid segmentation algorithm evaluated intraoperative dynamics of interface fluid before and after surgical manipulations. iOCT images were also captured at multiple intraoperative time points for two different DSAEK techniques, one that used an active air infusion system and one that did not. Main Outcome Measures interface fluid metrics, graft non-adherence Results iOCT measurements of interface fluid following final surgical manipulations and immediately prior to leaving the OR identified that Total Fluid Volume (p=0.002), Largest Fluid Volume Pocket (p=0.002), Max Fluid Area (p=0.006), Mean Fluid Thickness (p=0.03), and Max Fluid Thickness (p=0.01) significantly correlated with graft non-adherence rates within the first postoperative week. Following placement and optimization of intraoperative lenticle adherence, iOCT revealed a significant difference between the area, volume and thickness of maximum fluid pockets between the two surgical techniques, though both techniques resulted in significant reduction of interface fluid during the procedure. Conclusions Larger residual interface fluid volume, area, and thickness at the end of surgery detected with iOCT are associated with early graft non-adherence and can be quantified with an automated algorithm. iOCT imaging can successfully capture technique-dependent differences in fluid dynamics during DSAEK surgery.

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Section: Introductionmentioning

confidence: 99%

Intraoperative Interface Fluid Dynamics and Clinical Outcomes for Intraoperative Optical Coherence Tomography–Assisted Descemet Stripping Automated Endothelial Keratoplasty From the PIONEER Study

Hallahan

Cost

Goshe

et al. 2017

American Journal of Ophthalmology

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“…The introduction of swept-source OCT for ocular imaging allows improved sensitivity and signal-to-noise ratio compared with the previous models of spectral-domain OCT. 25 , 26 In a recently published study, we observed similar reliability between swept-source OCT and spectral-domain OCT with excellent interdevice agreement for measurement of LASIK flap thickness. 27 The purpose of the present study was to compare the reliability of corneal topographic measurements between swept-source OCT and Scheimpflug imaging in eyes before, and 1 year after femtosecond-assisted laser-assisted keratomileusis (LASIK).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Evaluation of Cornea With Swept-Source Optical Coherence Tomography and Scheimpflug Imaging Before and After Lasik

Chan

Biswas

et al. 2015

Medicine

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Swept-source optical coherence tomography (OCT) is the latest advancement in anterior segment imaging. There are limited data regarding its performance after laser in situ keratomileusis (LASIK). We compared the reliability of swept-source OCT and Scheimpflug imaging for evaluation of corneal parameters in refractive surgery candidates with myopia or myopic astigmatism. Three consecutive measurements were obtained preoperatively and 1 year postoperatively using swept-source OCT and Scheimpflug imaging. The study parameters included central corneal thickness (CCT), thinnest corneal thickness (TCT), keratometry at steep (Ks) and flat (Kf) axes, mean keratometry (Km), and, anterior and posterior best fit spheres (Ant and Post BFS). The main outcome measures included reliability of measurements before and after LASIK was evaluated using intraclass correlation coefficient (ICC) and reproducibility coefficients (RC). Association between the mean value of corneal parameters with age, spherical equivalent (SEQ), and residual bed thickness (RBT) and association of variance heterogeneity of corneal parameters and these covariates were analyzed. Twenty-six right eyes of 26 participants (mean age, 32.7 ± 6.9 yrs; mean SEQ, −6.27 ± 1.67 D) were included. Preoperatively, swept-source OCT demonstrated significantly higher ICC for Ks, CCT, TCT, and Post BFS (P ≤ 0.016), compared with Scheimpflug imaging. Swept-source OCT demonstrated significantly smaller RC values for CCT, TCT, and Post BFS (P ≤ 0.001). After LASIK, both devices had significant differences in measurements for all corneal parameters (P ≤ 0.015). Swept-source OCT demonstrated a significantly higher ICC and smaller RC for all measurements, compared with Scheimpflug imaging (P ≤ 0.001). Association of variance heterogeneity was only found in pre-LASIK Ant BFS and post-LASIK Post BFS for swept-source OCT, whereas significant association of variance heterogeneity was noted for all measurements except Ks and Km for Scheimpflug imaging.This study reported higher reliability of swept-source OCT for post-LASIK corneal measurements, as compared with Scheimpflug imaging. The reliability of corneal parameters measured with Scheimpflug imaging after LASIK was not consistent across different age, SEQ, and RBT measurements. These factors need to be considered during follow-up and evaluation of post-LASIK patients for further surgical procedures.

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“…Third, the repeatability and reproducibility of OCT parameters for anterior chamber were not assessed in the current study. Previously, it has been reported that corneal thickness measurements obtained with intraoperative OCT are highly consistent 23. In our study, in order to save time for the surgery, two experienced observers analysed the images together to reduce the possible selection bias.…”

Section: Discussionmentioning

confidence: 94%

“…A high-resolution and noninvasive imaging technique currently used in ophthalmology is optical coherence tomography (OCT), which has been introduced for examining children 18–20. In addition, intraoperative OCT in adults enables surgeons to visualise all steps of the endothelial keratoplasty procedure19 21 and to evaluate the changes of corneal thickness during cross-linking22 and in situ laser keratomileusis treatments,23 thereby decreasing surgery-related complications and improving clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Optimising keratoplasty for Peters' anomaly in infants using spectral-domain optical coherence tomography

et al. 2016

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Stromal Bed Thickness Measurement During Laser in Situ Keratomileusis Using Intraoperative Optical Coherence Tomography

Cited by 11 publications

References 15 publications

Intraoperative Interface Fluid Dynamics and Clinical Outcomes for Intraoperative Optical Coherence Tomography–Assisted Descemet Stripping Automated Endothelial Keratoplasty From the PIONEER Study

Intraoperative Interface Fluid Dynamics and Clinical Outcomes for Intraoperative Optical Coherence Tomography–Assisted Descemet Stripping Automated Endothelial Keratoplasty From the PIONEER Study

Longitudinal Evaluation of Cornea With Swept-Source Optical Coherence Tomography and Scheimpflug Imaging Before and After Lasik

Optimising keratoplasty for Peters' anomaly in infants using spectral-domain optical coherence tomography

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