title: Predictive value of optical coherence tomography in graft attachment after Descemet's membrane endothelial keratoplasty.
abstract: OBJECTIVE
  To evaluate the predictive value of early anterior segment optical coherence tomography (AS-OCT) on graft adherence or detachment after Descemet's membrane endothelial keratoplasty (DMEK).
  
  
  METHODS
  Retrospective study of prospectively collected data at a tertiary referral center.
  
  
  METHODS
  A total of 87 eyes of 87 patients of a consecutive series of 142 DMEK surgeries.
  
  
  METHODS
  Anterior segment OCT was performed within the first hour after DMEK and at 1 week, 1 month, 3 months, and 6 months, and for each time interval detachments were classified as "none," ≤ 1/3 detachment, >1/3 detachment of the total graft surface area, or "complete" detachment. Throughout the study, no rebubbling procedures were performed.
  
  
  METHODS
  Graft adherence at various postoperative time intervals.
  
  
  RESULTS
  One-hour AS-OCT scans were more accurate at predicting the final 6-month graft adherence status than those at 1 week or 1 month. Grafts showing complete attachment or <1/3 detachment at 1 hour remained stable or improved in 73% of the cases at 1 week, 82% at 1 month, 86% at 3 months, and 90% at 6 months. All grafts attached at 1 week remained attached at 6 months. Graft detachments of >1/3 at 1 hour showed reattachment at 6 months in 25% of the cases, whereas 67.5% of the cases showed a persistent detachment of >1/3 at 6 months and 12.5% showed a complete detachment.
  
  
  CONCLUSIONS
  The 1-hour AS-OCT scan showed the best predictive value on 6-month graft adherence status. The combined information of the 1-hour and 1-week AS-OCT scans may facilitate decision making about surgical reintervention after DMEK.
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
authors.forename: Ru-Yin
authors.initials: RY
authors.lastname: Yeh
authors.forename: Ruth
authors.initials: R
authors.lastname: Quilendrino
authors.forename: Fayyaz U
authors.initials: FU
authors.lastname: Musa
authors.forename: Vasilios S
authors.initials: VS
authors.lastname: Liarakos
authors.forename: Isabel
authors.initials: I
authors.lastname: Dapena
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000368:Aged; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000033:anatomy & histology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D013997:Time Factors; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology