Microscope Integrated Optical Coherence Tomography Guided Descemet Stripping Automated Endothelial Keratoplasty in Congenital Hereditary Endothelial Dystrophy
Mohamed Ibrahime Asif,1 Rahul Kumar Bafna,1 Namrata Sharma,1 Ananya Kaginalkar,1 Rajesh Sinha,1 Tushar Agarwal,1 Prafulla Kumar Maharana,1 Manpreet Kaur,1 Priya Taank,2 Jeewan S Titiyal1 1Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2D...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/7549eae4fce24f009ddbee4552eb0202 |
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| Sumario: | Mohamed Ibrahime Asif,1 Rahul Kumar Bafna,1 Namrata Sharma,1 Ananya Kaginalkar,1 Rajesh Sinha,1 Tushar Agarwal,1 Prafulla Kumar Maharana,1 Manpreet Kaur,1 Priya Taank,2 Jeewan S Titiyal1 1Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Department of Ophthalmology, Command Hospital, Pune, 411040, IndiaCorrespondence: Namrata SharmaDepartment of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, IndiaTel +91 9810856988Fax +91 11-26588919Email namrata.sharma@gmail.comPurpose: To describe the outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) in congenital hereditary endothelial dystrophy (CHED) and to evaluate the role of microscope integrated optical coherence tomography (Mi-OCT) during the surgery.Design: Retrospective data analysis.Methods: A retrospective study from the medical records of all those patients who were diagnosed with CHED and underwent DSAEK at our centre from 2015 were evaluated. All patients underwent Mi-OCT-guided standard DSAEK procedure. Intra-operative difficulties, visual outcomes and graft survival were recorded.Results: A total of 48 eyes of 29 patients with a mean age of 9.87 ± 8.2 years and mean follow-up of 17.3 months were evaluated. Thirty-nine eyes underwent primary DSAEK and 9 eyes underwent PKP. Three eyes who underwent PKP had failed graft for which they underwent DSAEK. The mean preoperative Snellen’s visual acuity was 1.71 ± 0.66 and the mean preoperative central corneal thickness was 1.10 ± 0.174 mm. Intraoperatively, all the grafts were attached which was confirmed using Mi-OCT. Graft detachment was seen in the immediate postoperative period in 10.4% (4 eyes) of primary DSAEK, out of which DM scoring was not performed in 2 eyes. Following DSAEK, cornea cleared at four-week follow-up in 89.7% eyes and in all the eyes the cornea cleared at six-week follow-up.Conclusion: Primary DSAEK could be a preferred option over PKP for CHED with early presentation and in those eyes with failed primary PKP. Mi-OCT is a very useful tool in these eyes for various intraoperative procedures, thereby improving the outcomes of the procedure.Keywords: DSAEK, CHED, Mi-OCT |
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