ÖN SEQMENT OPTİK KOHERENT TOMOQRAFİYANIN (ÖS-OKT), DESEMET MEMBRANIN SOYULMASI İLƏ ENDOTELİAL KERATOPLASTİKADAN SONRA YARARLIĞI

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SUMMARY

Purpose: To evaluate the dynamics of cornea and graft thickness after Descemet stripping and endothelial
keratoplasty (DSEK) using anterior segment optical coherence tomography (AS-OCT) and to assess the usefulness
of AS-OCT in monitoring graft adherence after DSEK.

Material and methods
9 eyes from 9 patients underwent DSEK for Fuchs endothelial dystrophy or
pseudophakic bullous keratopathy. Central corneal thickness (CCT), endothelial graft thickness (GT), interface
fluid presence, graft dislocation, rate of CCT, and GT changes were measured with an AS-OCT during 1 week, 1
month and 3 months follow up.

Results
The recipient CCT averaged 818.56 pm preoperatively. On postoperative 1 week, 1 month and 3
months mean CCT was 573.44pm, 513.11pm, 480.22pm and GT was 172.11pm, 140.78pm, 129.22pm. Compared
with CCT on the first day, the changes in CCT on 1 week, 1 month and 3 months were statistically significant (P
< 0.0001). The CCT dynamics is closely correlated with changes of GT and of the recipient's part of cornea. The
most rapid rate of thickness decrease was observed between preoperative and 1st week (35.017 pm/day) and 1st
week to 1 month 2.623 pm/day for the entire cornea and 1.362 pm/day for endothelial disc. Between 1 month and
3 months, the CCT and GT were stable with only a trend toward further decrease. Entrapped fluid at graft/host
interface on the first postoperative day was detectable by slit-lamp examination in 1 eye (11.11%) and in 3 eyes
(33.33%)inOCT.

Conclusion
The recovery of endothelial pump after DSEK takes place between 1 week and 1 month after
DSEK. AS-OCT can be practically used for evaluation of the cornea and transplant dynamics as well as for the
qualitative and quantitative assessment of graft-host interface after DSEK.