title: Intraoperative OCT-Assisted DMEK: 14 Consecutive Cases.
abstract: OBJECTIVE
  To describe the utility of a new intraoperative optical coherence tomographer (OCT) to evaluate endothelio-Descemet graft orientation during Descemet membrane endothelial keratoplasty (DMEK) procedures.
  
  
  METHODS
  Prospective, observational, and single-center pilot case series including 14 eyes of 14 patients consecutively scheduled for DMEK surgery. After injecting the graft into the anterior chamber, the graft orientation was assessed with the help of anterior segment OCT. The surgical time and unfolding time were measured. The postoperative measurements included best-corrected visual acuity, central pachymetry, and specular microscopy at 1 month.
  
  
  RESULTS
  Using the OCT images, it was possible to evaluate the graft orientation in all cases. The mean unfolding time was 6.1 ± 3.0 minutes, the mean best-corrected visual acuity was 0.3 ± 0.3 logarithm of the minimum angle of resolution, the mean decrease in central pachymetry was 213 ± 177 μm, and the mean central endothelial cell count was 1906 ± 319 cells per square millimeter.
  
  
  CONCLUSIONS
  Live intraoperative OCT is useful to visualize and assess graft orientation in DMEK surgery. It enables faster graft positioning with less graft manipulation in the presence of severe corneal edema.
authors.affiliation: *Anterior Segment and Refractive Surgery Department, Rothschild Foundation, Paris, France; †Center for Expertise and Research in Optics for Clinicians (CEROC); and ‡French Eye Bank, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Saad
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Guilbert
authors.forename: Alice
authors.initials: A
authors.lastname: Grise-Dulac
authors.forename: Patrick
authors.initials: P
authors.lastname: Sabatier
authors.forename: Damien
authors.initials: D
authors.lastname: Gatinel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D063171:Corneal Pachymetry; D003886:Descemet Membrane / Q000473:pathology*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology*; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D007640:Keratoconus / Q000601:surgery; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology