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Wydanie 3/2011
str. 59

Obrazowanie przedniego odcinka oka za pomocą OCT Visante Omni u pacjentów po przeszczepie warstwowym tylnym wykonanym za pomocą lasera femtosekundowego

Anterior Segment Imaging Using OCT Visante Omni in Patients after Posterior Lamellar Keratoplasty Procedure Using Femtosecond Laser

Michał Milka^1,2, Edward Wylęgała^1,2, Dariusz Dobrowolski^1,2, Anita Lyssek-Boroń^1,2, Anna Nowińska², Daniela Milka³

¹ Oddział Okulistyczny Wojewódzkiego Szpitala Specjalistycznego nr 5 w Sosnowcu
  Ordynator: dr n. med. Dariusz Dobrowolski
² Oddział Okulistyczny Okręgowego Szpitala Kolejowego w Katowicach
  Ordynator: prof. dr hab. n. med. Edward Wylęgała
³ Katedra i Zakład Anatomii Prawidłowej Śląskiego Uniwersytetu Medycznego w Katowicach
  Kierownik: dr hab. n. med. Grzegorz Bajor

Summary: Purpose: To evaluate efficacy and usefulness of the new anterior segment TD OCT (Time Domain) device, before and after femtosecond laser (LF) assisted endothelial keratoplasty (FLEK) in patients with pseudophakic bullous keratopathy.
Material and methods: 27 patients, 16 women 11 men (mean age 61.4 ± 14.2) after FLEK procedure were included in the study and examined before, 1 week, 3 and 6 months after surgery. In all patients we performed high-resolution anterior segment OCT scans of the cornea (Visante Omni Carl Zeiss Meditec). We estimated graft adherence, presence of the cornea interface fluid, presence of Descemet’s folds and postoperative complications. We also measured mean central corneal thickness (CCT) and posterior lamellar thickness.
Results: Postoperative OCT images of the recipient cornea were able to provide many important clinical information. In our group of patients, we observed graft dislocation in 3 cases (11.1%), graft detachment in 2 cases (7.4%), Descemet’s folds in 4 cases (14.8%) and interface fluid in 6 cases (22.2%). We also observed primary graft failure in 1 case (3.7%). 6 months after keratoplasty 3 corneas remained cloudy. Beside anterior segment morphology images, we also received valusale morphometric data. Before surgery mean CCT was 804 ± 193 μm, 1 week after surgery was 693 ± 49 μm, 3 months after surgery was 597 ± 86 μm and 6 months after surgery was 582,54 ± 56,91 µm, respectively. Posterior lamellar thickness 1 week after surgery was 128 ± 36,91 µm, 3 months after surgery was 96 ± 23,54 µm and 6 months after surgery was 82 ± 28,76 µm, respectively.
Conclusions: OCT Visante Omni is effective, non contact method of corneal pre- and postoperative imaging. This imaging method with proper surgery technique increase efficiency of Lamellar Keratoplasty procedures also allows to reduce or avoid some complications.

Słowa kluczowe: OCT przedniego odcinka, przeszczep warstwowy tylny, laser femtosekundowy.

Keywords: anterior segment OCT, posterior lamellar keratoplasty, femtosecond laser.

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