November 20, 2013
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AS-OCT can help fine-tune surgical maneuvers, modifications for repeat keratoplasty

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NEW ORLEANS — A study evaluating an optical coherence tomography-based protocol for the management of failed penetrating keratoplasty determined that imaging of the anterior segment after failure improves planning for repeat surgery, according to a poster presentation here.

Fifty-five patients with a failed graft were included in the study, with their primary inclusion factor being corneal scar. In total, 440 graft-host junctions were analyzed using the Visante AS-OCT (Carl Zeiss Meditec) for anterior/posterior malapposition, according to the poster at the American Academy of Ophthalmology meeting.

“A repeat keratoplasty often poses numerous surgical challenges and surprises,” the study authors said in the poster. “A preoperative imaging of the anterior segment and graft profile may help in combating these surprises and choosing appropriate surgical maneuvers and modifications to provide optimal results. Although the decision for the choice of case-appropriate surgical therapy in the form of repeat PK vs. DSEK is usually made clinically, AS-OCT may largely help in confirming the clinical results.”

In addition, the authors said that placement of an Ahmed glaucoma valve (AGV, New World Medical) into the anterior chamber or pars plana depends on the space available in the anterior chamber, so therefore, “management of coexisting glaucoma using AGV may be facilitated using the AS-OCT.”

Disclosure: The study authors have no relevant financial disclosures.