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Klin Monbl Augenheilkd 2023; 240(04): 398-399
DOI: 10.1055/a-2004-5245
Der interessante Fall

iOCT-Assisted DSAEK Tamponade for Spontaneous Corneal Perforation with Secondary Bleb Formation in Pellucid Marginal Degeneration

iOCT-assistierte DSAEK-Tamponade bei spontaner Hornhautperforation mit sekundärer Filterkissenbildung aufgrund einer pelluziden marginalen Degeneration
Aja Reinhold
1   Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
,
Pascal W. Hasler
1   Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
2   IOB – Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
,
Hendrik P. N. Scholl
1   Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
2   IOB – Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
,
Zisis Gatzioufas
1   Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
2   IOB – Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
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Background

Intraoperative optical coherence tomography (iOCT) is used extensively in complex anterior segment surgery, providing increased precision and thereby more safety and improved clinical outcomes. In lamellar keratoplasty, the successful application of iOCT has already been described [1]. For example, the iOCT can be used for defining the cutting depth of deep anterior lamellar keratoplasty (DALK) or for visualization of potential fluid in the interface in Descemet stripping automated endothelial keratoplasty (DSAEK) [2], [3], [4]. Moreover, for the correct corneal graft positioning in Descemet membrane endothelial keratoplasty (DMEK), a marker was previously required. The iOCT allows recognition of the corneal graft orientation and further observation of the unfolding process of the graft without the need for marking [1], [5].

Hereby we report on a 49-year-old patient with pellucid marginal degeneration, who presented with spontaneous corneal perforation and secondary bleb formation due to internal fistula formation. He was successfully treated with iOCT-assisted DSAEK tamponade.



Publication History

Received: 27 September 2022

Accepted: 22 December 2022

Article published online:
25 April 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
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  • References

  • 1 Carlà MM, Boselli F, Giannuzzi F. et al. An Overview of Intraoperative OCT-Assisted Lamellar Corneal Transplants: A Game Changer?. Diagnostics (Basel) 2022; 12: 272
    CrossrefPubMedSearch in Google Scholar
  • 2 Mimouni M, Kronschläger M, Ruiss M. et al. Intraoperative optical coherence tomography guided corneal sweeping for removal of remnant Interface fluid during ultra-thin Descemet stripping automated endothelial keratoplasty. BMC Ophthalmol 2021; 21: 180
    CrossrefPubMedSearch in Google Scholar
  • 3 Hallahan KM, Cost B, Goshe JM. et al. Intraoperative Interface Fluid Dynamics and Clinical Outcomes for Intraoperative Optical Coherence Tomography-Assisted Descemet Stripping Automated Endothelial Keratoplasty From the PIONEER Study. Am J Ophthalmol 2017; 173: 16-22
    CrossrefPubMedSearch in Google Scholar
  • 4 Juthani VV, Goshe JM, Srivastava SK. et al. Association between transient interface fluid on intraoperative OCT and textural interface opacity after DSAEK surgery in the PIONEER study. Cornea 2014; 33: 887-892
    CrossrefPubMedSearch in Google Scholar
  • 5 Muijzer MB, Soeters N, Godefrooij DA. et al. Intraoperative Optical Coherence Tomography-Assisted Descemet Membrane Endothelial Keratoplasty: Toward More Efficient, Safer Surgery. Cornea 2020; 39: 674-679
    CrossrefPubMedSearch in Google Scholar
  • 6 Bahar I, Kaiserman I, Levinger E. et al. Retrospective contralateral study comparing descemet stripping automated endothelial keratoplasty with penetrating keratoplasty. Cornea 2009; 28: 485-488
    CrossrefPubMedSearch in Google Scholar