The first experience ofapplyingintraoperative optical coherence tomographyin lamellar corneal surgery

    Abstract

    The first experience ofapplyingintraoperative optical coherence tomographyin lamellar corneal surgery

    Demyanchenko S.K., Tereshchenko A.V., Trifanenkova I.G., Vishnyakova E.N., Golubeva Yu.Yu.

    The Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution

    Purpose. To evaluate feasibility of intraoperative optical coherence tomography using Hi-R NEO 900A N/R (Haag-Streit Surgical, Germany) with the integrated optical coherence tomography OCT 3rdgeneration for making deep anterior lamellar keratoplasty and transplantation of the Descemet's membrane.

    Material and methods. Four operations of deep anterior lamellar keratoplasty by reason of stage III-IV of keratoconusand six transplantationsof the Descemet's membranewith theendothelial layerby reason ofsecondary corneal endothelial dystrophywere made with using the operating microscope Hi-R NEO 900A N/R (Haag-Streit Surgical, Germany) with the integrated optical coherence tomography OCT 3rd generation.

    Results. When performing deep anterior lamellar keratoplasty, the stage of resectionof the outer layers of the corneawas very controllable and dosed in all cases without risk of corneal perforation, thanks to the presence of detailed information about corneal thickness of patientinmode of real time.When transplantation of a descemet's membraneoccurred,OCT gaveirreplaceable information about theposition of endothelial transplantin the anterior chamber of the eye andorientation of its endothelial layer.

    Conclusion. Method of intraoperative OCT using Hi-R NEO 900A N/R (Haag-Streit Surgical, Germany) with the integrated optical coherence tomography OCT 3rd generation showed itself as an indispensable toolin corneal surgery, giving more higher level of predictabilityof course ofsurgical intervention. Advantages of applying intraoperativeOCTin maximum degree appear themselvesin case of deterioration of cornealclearness, when capabilitiesof standard optical microscopy do not let show ultrathin structures of acornea.

    Key words: intraoperative optical coherence tomography, deep anterior lamellar keratoplasty transplantation of the Descemet's membrane.