title: Evaluation of Early Graft Detachment After Descemet Membrane Endothelial Keratoplasty Using New Swept-Source Optical Coherence Tomography.
abstract: OBJECTIVE
  To evaluate the ability of Swept-source optical coherence tomography (SS-OCT) in detecting early endothelial graft detachment after Descemet membrane endothelial keratoplasty (DMEK) and to determine the possible causes of graft detachment using 2 different protocols for anterior segment (AS) imaging.
  
  
  METHODS
  Eight eyes from 8 consecutive DMEK surgeries were evaluated. High-resolution images were captured with SS-OCT using 2 different radial protocols for AS imaging (16- and 6-mm radial protocols). Central and peripheral corneal changes were evaluated.
  
  
  RESULTS
  All eyes developed early graft detachment detectable with the SS-OCT. The 16-mm radial protocol scanned the cornea detecting early graft detachment in 6 out of 8 cases. The 6-mm radial protocol provided detailed images of the cornea, detecting early detachment in all cases. Stromal irregularities and small remnants only detectable using SS-OCT were the possible cause of detachment in 3 cases. One of the 8 eyes had air reinjection. The detachment in that eye was apparent by slit-lamp examination. The detachments spontaneously resolved in the other 7 eyes. AS SS-OCT evaluation was found to have added diagnostic value to biomicroscopy in 5 of these eyes (64.5%).
  
  
  CONCLUSIONS
  AS SS-OCT is sensitive in detecting early graft detachment after DMEK. The 16-mm radial protocol of Triton SS-OCT is superior regarding quick scan of the entire cornea providing a general visualization of the DMEK graft. The 6-mm radial protocol provides detailed corneal imaging of a selected area, which is useful for evaluating structural alterations that are not detectable with larger scans and may affect the adherence of the endothelial graft.
authors.affiliation: *IIS-Aragón, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain; †Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; and ‡Department of Ophthalmology, Naval Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Satue
authors.forename: Miriam
authors.initials: M
authors.lastname: Idoipe
authors.forename: Antonio
authors.initials: A
authors.lastname: Sanchez-Perez
authors.forename: Vasilis S
authors.initials: VS
authors.lastname: Liarakos
authors.forename: Antonio
authors.initials: A
authors.lastname: Mateo
authors.forename: Elena
authors.initials: E
authors.lastname: Garcia-Martin
authors.forename: Vicente
authors.initials: V
authors.lastname: Polo
authors.forename: Alicia
authors.initials: A
authors.lastname: Gavin
authors.forename: Carlos
authors.initials: C
authors.lastname: Brito
mesh_terms: D000869:Anterior Eye Segment / Q000000981:diagnostic imaging*; D002452:Cell Count; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects*; D004728:Endothelium, Corneal / Q000000981:diagnostic imaging / Q000473:pathology*; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D007431:Intraoperative Complications; D012307:Risk Factors; D041623:Tomography, Optical Coherence / Q000379:methods*