title: Optimising deep anterior lamellar keratoplasty  (DALK) using intraoperative online optical coherence  tomography (iOCT).
abstract: OBJECTIVE
  To describe the use of intraoperative online optical coherence tomography (iOCT) for improving deep anterior lamellar keratoplasty (DALK) surgery.
  
  
  METHODS
  Retrospective case series of 6 eyes of 6 male patients with keratokonus, corneal dystrophy or herpetic stromal scars undergoing DALK were investigated using intraoperative optical coherence tomography and postsurgical image/video analysis. Main outcome measures were: visibility of surgical steps, especially, assessment of placement depth of injection needle, preparation of bare Descemet's membrane and drainage of interface fluid.
  
  
  RESULTS
  iOCT enables real-time visualisation of all surgical steps of DALK procedure in all patients. Placement of air injection needle above Descemet's membrane was reliably monitored as was presence of bare Descemet's membrane and potential interface fluid.
  
  
  CONCLUSIONS
  iOCT assists with visualisation of injection needle placement and with assessment of bare Descemet's membrane as well as interface fluid during the DALK procedure. Overall iOCT may be a helpful device that supports surgeons in all steps of DALK procedure.
authors.forename: Philipp
authors.initials: P
authors.lastname: Steven
authors.forename: Carolin
authors.initials: C
authors.lastname: Le Blanc
authors.forename: Eva
authors.initials: E
authors.lastname: Lankenau
authors.forename: Marc
authors.initials: M
authors.lastname: Krug
authors.forename: Stefan
authors.initials: S
authors.lastname: Oelckers
authors.forename: Ludwig M
authors.initials: LM
authors.lastname: Heindl
authors.forename: Uta
authors.initials: U
authors.lastname: Gehlsen
authors.forename: Gereon
authors.initials: G
authors.lastname: Huettmann
authors.forename: Claus
authors.initials: C
authors.lastname: Cursiefen
mesh_terms: D000328:Adult; D003199:Computer Systems; D003316:Corneal Diseases / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009862:Online Systems; D009924:Organ Culture Techniques; D011184:Postoperative Period; D012189:Retrospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014741:Video Recording