title: Visualization of precut DSAEK and pre-stripped DMEK donor corneas by intraoperative optical coherence tomography using the RESCAN 700.
abstract: BACKGROUND
  To report the feasibility of intraoperative spectral domain optical coherence tomography (OCT) using the RESCAN 700 for the visualization and evaluation of precut Descemet's stripping automated endothelial keratoplasty (DSAEK) and prestripped Descemet's membrane endothelial keratoplasty (DMEK) donor tissue.
  
  
  METHODS
  Precut DSAEK (n = 11), prestripped DMEK (n = 4) preserved in a viewing chamber were examined by intraoperative OCT. Wholly intact donor corneas for penetrating keratoplasty (PK) (n = 8) were also examined as controls. The obtained images were analyzed qualitatively for characteristics of each type of donor.
  
  
  RESULTS
  For each type of donor, characteristic images were consistently obtained by intraoperative OCT in both the front and back views through the viewing chamber. In wholly intact donors for PK, appearance of normal corneal curvature and stromal texture with high reflectivity of epithelium and endothelium cell layers were clearly visualized. In precut DSAEK donors, precut lines were characteristically visualized in addition to the intact donor cornea images. In prestripped DMEK donors, identical OCT images to the intact donor cornea were noted when observed from the anterior surface. However, peripheral partial detachments of Descemet's membrane were characteristically observed in all prestripped DMEK donors when viewed from the back of the viewing chamber.
  
  
  CONCLUSIONS
  Rapid visualization and rough evaluation of donor tissues for PK, precut DSAEK and prestripped DMEK donor corneas by intraoperative OCT was consistently possible through the viewing chamber. Therefore, this device may be used as an alternative of AS-OCT when the eyebank does not have their own AS-OCT. Although the peripheral detachment in DMEK donors are quite common and clinically non-problematic in DMEK donor quality and subsequent DMEK surgeries, it may be useful to distinguish between wholly intact PK donors and prestripped DMEK donors, enabling to prevent mix-ups of donors, especially when several different types of keratoplasties are scheduled in a same day in one operating theater.
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan. kobaya@kenroku.kanazawa-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokogawa
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Mori
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sugiyama
mesh_terms: D003316:Corneal Diseases / Q000601:surgery; D003886:Descemet Membrane / Q000000981:diagnostic imaging* / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D006801:Humans; D007432:Intraoperative Period; D015948:Keratoplasty, Penetrating / Q000379:methods*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting; D041623:Tomography, Optical Coherence
keywords: Descemet’s membrane endothelial keratoplasty; Descemet’s stripping automated endothelial keratoplasty; Intraoperative OCT; RESCAN 700