title: Detection of graft detachments immediately following Descemet membrane endothelial keratoplasty (DMEK) comparing time domain and spectral domain OCT.
abstract: OBJECTIVE
  Correct early graft attachment is believed to be crucial for final visual outcome after Descemet membrane endothelial keratoplasty (DMEK). Nonetheless, it is not yet known which imaging technique gives superior results for examining early postoperative graft adherence status. We compared imaging data taken with two different OCT devices to examine the development of graft adherence immediately after DMEK and to determine the superior device in terms of visualization of graft adherence.
  
  
  METHODS
  Ten consecutive patients (1 man/9 women) were examined three times postoperatively within the first 7 h after DMEK surgery using spectral domain OCT (SD-OCT) and time domain OCT (TD-OCT), as prospective case series and retrospective image data analyses. The parameters analyzed were localization and number, visibility and size of graft detachments.
  
  
  RESULTS
  TD-OCT was able to detect a greater number of graft detachments after DMEK; however, SD-OCT provided better resolution of minor detachments. Graft detachments varied in position and degree at different time points immediately after surgery. All patients had some graft detachment within the first 7 h after DMEK surgery.
  
  
  CONCLUSIONS
  TD-OCT enabled better overall analysis of graft detachments, even in the periphery, whereas SD-OCT allowed for the detection of even minor detachments, which suggests that a combination of the two techniques is optimal. Our results indicate that dynamic processes affecting the DMEK graft immediately after transplantation are responsible for changes in the attachment of donor tissue at an early postoperative stage. Modulation of early graft attachment may improve the final graft attachment.
authors: Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany. Sebastian.Siebelmann@uk-koeln.de.|Cluster of Excellence: Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany. Sebastian.Siebelmann@uk-koeln.de.
authors: Sebastian
authors: S
authors: Siebelmann
authors: Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany.
authors: Uta
authors: U
authors: Gehlsen
authors: Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany.
authors: Carolin
authors: C
authors: Le Blanc
authors: Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.
authors: Tisha Prabriputaloong
authors: TP
authors: Stanzel
authors: Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.
authors: Claus
authors: C
authors: Cursiefen
authors: Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany.
authors: Philipp
authors: P
authors: Steven
mesh_terms: D000368:Aged; D003886:Descemet Membrane / Q000473:pathology*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006084:Graft Rejection / Q000175:diagnosis* / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity
keywords: DMEK; Detachments; Graft changes; Optical coherence tomography