title: Optical coherence tomography, Scheimpflug imaging, and slit-lamp biomicroscopy in the early detection of graft detachment after Descemet membrane endothelial keratoplasty.
abstract: OBJECTIVE
  To evaluate the efficacy of anterior segment optical coherence tomography (OCT), Scheimpflug imaging, and slit-lamp biomicroscopy in the early detection of a (partial) graft detachment after Descemet membrane endothelial keratoplasty (DMEK).
  
  
  METHODS
  Anterior segment OCT, Scheimpflug imaging, and slit-lamp biomicroscopy were performed in 120 eyes of 110 patients after DMEK.
  
  
  RESULTS
  Seventy-eight eyes showed a normal corneal clearance, and the attached Descemet grafts could not be identified with any of the imaging techniques. Forty-two eyes showed persistent stromal edema in the first postoperative month. In transplanted corneas that (partially) did not clear in the early postoperative period, OCT had an added diagnostic value in 36% of cases (15 of 42 eyes) in visualizing whether the graft was detached and, in particular, to discriminate between a "flat" graft detachment and delayed corneal clearance. In contrast, in the presence of corneal edema, Scheimpflug imaging did not provide more information than slit-lamp biomicroscopy in the detection of a graft detachment.
  
  
  CONCLUSIONS
  Anterior segment OCT may be an effective tool in the detection of an early graft detachment after DMEK, to determine if secondary surgical intervention is indicated or is to be avoided.
authors: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
authors: Kyros
authors: K
authors: Moutsouris
authors: Isabel
authors: I
authors: Dapena
authors: Lisanne
authors: L
authors: Ham
authors: Chandra
authors: C
authors: Balachandran
authors: Silke
authors: S
authors: Oellerich
authors: Gerrit R J
authors: GR
authors: Melles
mesh_terms: D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty; D003941:Diagnostic Techniques, Ophthalmological; D042241:Early Diagnosis; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008853:Microscopy / Q000379:methods; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*