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Chapter-23 Optical Coherence Tomography Guided Pre-Descemet’s Endothelial Keratoplasty

BOOK TITLE: Pre-Descemet’s Endothelial Keratoplasty (PDEK)

Author
1. Jacob Soosan
ISBN
9789352703036
DOI
10.5005/jp/books/14154_24
Edition
1/e
Publishing Year
2018
Pages
6
Author Affiliations
1. Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road Chennai, Tamil Nadu, India, Dr Agarwal’s Group of Eye Hospitals, Refractive and Cornea Foundation, Chennai, Tamil Nadu, India, Dr Agarwal’s Refractive and Cornea Foundation (DARCF); Dr Agarwal’s Group of Eye Hospitals, Chennai, Tamil Nadu, India, Dr Agarwal’s Refractive and Cornea Foundation, Dr Agarwal’s Group of Eye Hospitals, Chennai, Tamil Nadu, India, Dr Agarwal’s Refractive and Cornea, Foundation, Dr Agarwal’s Group of Eye Hospitals, Chennai, Tamil Nadu, India, Dr Agarwal's Group of Eye Hospitals, Chennai, Tamil Nadu, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Center, Chennai, Tamil Nadu, India, Dr. Agarwal’s Group of Eye Hospitals Chennai, India, Dr Agarwal’s Group of Eye Hospitals, and Eye Research Centre, 19 Cathedral Road, Chennai, India, Dr. Agarwal’s Group of Eye Hospitals, Chennai, India, Dr. Agarwal’s Group of Eye Hospitals and Eye Research Centre, Chennai, India, Dr Agarwal
Chapter keywords
Optical coherence tomography, OCT, pre-Descemet’s endothelial keratoplasty, PDEK, anterior chamber, graft orientation

Abstract

This chapter seeks to familiarize the readers with optical coherence tomography guided pre-Descemet’s endothelial keratoplasty (PDEK). The challenge in performing both Descemet’s membrane endothelial keratoplasty (DMEK) as well as PDEK lies in the thin nature of the donor tissue that hinders with proper identification of the orientation of the graft within the anterior chamber (AC). Real-time intraoperative optical coherence tomography (OCT) is a new tool that can be used effectively to delineate structures better in three-dimension. The OCT can be useful in vitreoretinal surgeries as well as in lamellar corneal surgeries. Hand held OCT is also now available which can be used intraoperatively for the required steps of surgery. Though the OCT gives good depth perception and decreases the number of intracameral maneuvers required to confirm orientation, it still provides only a slit section of the graft and therefore does not give the instantaneous ability to see the entire graft from end-to-end in three-dimension. It is a much more economical and easily available alternative and aids in all steps by increasing depth perception by the surgeon.

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