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Optimising deep anterior lamellar keratoplasty (DALK) using intraoperative online optical coherence tomography (iOCT).
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To
describe
the
use
of
intraoperative
online
optical
coherence
tomography
(
iOCT
)
for
improving
deep
anterior
lamellar
keratoplasty
(
DALK
)
surgery
.
Retrospective
case
series
of
6
eyes
of
6
male
patients
with
keratokonus
,
corneal
dystrophy
or
herpetic
stromal
scars
undergoing
DALK
were
investigated
using
intraoperative
optical
coherence
tomography
and
postsurgical
image
/
video
analysis
.
Main
outcome
measures
were
:
visibility
of
surgical
steps
,
especially
,
assessment
of
placement
depth
of
injection
needle
,
preparation
of
bare
Descemet
's
membrane
and
drainage
of
interface
fluid
.
iOCT
enables
real-time
visualisation
of
all
surgical
steps
of
DALK
procedure
in
all
patients
.
Placement
of
air
injection
needle
above
Descemet
's
membrane
was
reliably
monitored
as
was
presence
of
bare
Descemet
's
membrane
and
potential
interface
fluid
.
iOCT
assists
with
visualisation
of
injection
needle
placement
and
with
assessment
of
bare
Descemet
's
membrane
as
well
as
interface
fluid
during
the
DALK
procedure
.
Overall
iOCT
may
be
a
helpful
device
that
supports
surgeons
in
all
steps
of
DALK
procedure
.
