Intraoperative use of AS-OCT during intrastromal corneal ring segment implantation.
OBJECTIVE
To evaluate femtosecond laser-created tunnels intraoperatively by anterior segment optical coherence tomography (AS-OCT) during intrastromal corneal ring segment implantation.


METHODS
The study prospectively examined 13 eyes of 11 patients who underwent intrastromal corneal ring segment surgery with the aid of femtosecond laser. All eyes had keratoconus as the primary diagnosis. Eyes were examined by AS-OCT to image the tunnel immediately after femtosecond laser and before ring segment implantation. Tunnel depth was calculated automatically using the software's flap tool and calipers.


RESULTS
The presence of air bubbles demonstrated the tunnel successfully by AS-OCT. Tunnel depth was measured at eight locations in four cross-sections of high-resolution cornea images. An overall evaluation was also made by changing the scan direction 360°. After confirmation that a uniform tunnel was satisfactorily created at the aimed depth, surgery proceeded with segment implantation.


CONCLUSIONS
AS-OCT can be used intraoperatively to assess femtosecond laser-created tunnel in intrastromal corneal ring segment implantation. The qualitative and quantitative evaluation of the intrastromal tunnel by AS-OCT before implantation of the ring segments is a practical intraoperative approach that may offer a safer surgery.
Medical Faculty, Department of Ophthalmology, Yeditepe University, Istanbul, Turkey. berilkucumen@hotmail.com
Raciha Beril
RB
Kucumen
Ebru
E
Gorgun
Nursal Melda
NM
Yenerel
Canan Asli
CA
Utine
D000293:Adolescent; D000328:Adult; D000869:Anterior Eye Segment / Q000473:pathology; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D007640:Keratoconus / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D041623:Tomography, Optical Coherence / Q000379:methods*; D055815:Young Adult