High-resolution optical coherence tomography-guided donor tissue preparation for descemet membrane endothelial keratoplasty using the reverse big bubble technique.
High-resolution optical coherence tomography-guided donor tissue preparation for descemet membrane endothelial keratoplasty using the reverse big bubble technique.
复制标题
使用反向大气泡技术进行高分辨率光学相干断层扫描引导的供体组织制备，用于后弹力膜内皮角膜移植术。
DOI：
10.1097/ico.0000000000000070
复制
发表时间：
2014
期刊：
影响因子：
2.8
通讯作者：
Kymionis,GeorgeD
中科院分区：
文献类型：
--
作者：
Cabot,Florence;Kankariya,VardhamanP;Ruggeri,Marco;Yoo,SoniaH;Vaddavalli,PravinK;Parel,Jean-Marie;Kymionis,GeorgeD
目的：本研究的目的是评估高分辨率谱域光学相干断层扫描（HR-SDOCT）在使用反向大气泡技术的后弹力层内皮角膜移植术中指导供体组织准备的可行性。方法：本体外实验研究中包括三个角巩膜盘。由 3 名不同的外科医生将 27-G 插管插入每个角膜的周边。每个外科医生都试图达到插管尖端的理想深度（前后弹力层平面），以进行空气注射，以产生反向大气泡，将后弹力层 (DM) 与后基质分离。采用Bascom Palmer眼科研究所眼科生物物理中心搭建的仰卧光学相干断层扫描系统，在组织制备过程中实时估计插管尖端在后基质中到达的深度。结果：空气注射后，成功获得1个大气泡，而其他角巩膜盘均出现基质内气肿和DM穿孔。在 HR-SDOCT 评估中，在插管尖端发现了伪影。成功的大气泡证明了 DM 和基质的分离，而没有基质内的高反射性。肺气肿在 HR-SDOCT 上可视化为遮蔽前房后部结构的高密度基质区域。结论：HR-SDOCT 引导的反向大气泡技术可能是后弹力层内皮角膜移植术中制备供体组织的有用方法。这项有前途的技术需要进一步改进高分辨率光学相干断层扫描技术。
Purpose:The aim of this study was to assess the feasibility of high-resolution spectral domain optical coherence tomography (HR-SDOCT) to guide donor tissue preparation in Descemet membrane endothelial keratoplasty using the reverse big bubble technique.Methods:Three corneoscleral discs were included in this ex vivo experimental study. A 27-G cannula was introduced into each cornea at the periphery by 3 different surgeons. Each surgeon attempted to achieve the ideal depth (pre-Descemetic plane) of the tip of the cannula for air injection to produce the reverse big bubble to separate the Descemet membrane (DM) from the posterior stroma. A supine optical coherence tomography system built at the Ophthalmic Biophysics Center of the Bascom Palmer Eye Institute was used to estimate in real-time the depth reached by the tip of the cannula in the posterior stroma during tissue preparation.Results:After air injection, 1 successful big bubble was obtained, while each of the other corneoscleral discs had intrastromal emphysema and DM perforation. On HR-SDOCT evaluations, artifacts were noticed at the tip of the cannula. The successful big bubble demonstrated the separation of the DM and the stroma without intrastromal hyperreflectivity. Emphysema was visualized on the HR-SDOCT as a hyperdense intrastromal area shadowing the posterior structures of the anterior chamber.Conclusions:The HR-SDOCT–guided reverse big bubble technique may be a useful method to prepare donor tissue in Descemet membrane endothelial keratoplasty. Further improvements in high-resolution optical coherence tomography technology are needed this promising technique.