Universität zu Köln

Siebelmann, Sebastian, Horstmann, Jens, Scholz, Paula, Bachmann, Bjoern, Matthaei, Mario, Hermann, Manuel and Cursiefen, Claus (2018). Intraoperative changes in corneal structure during excimer laser phototherapeutic keratectomy (PTK) assessed by intraoperative optical coherence tomography. Graefes Arch. Clin. Exp. Ophthalmol., 256 (3). S. 575 - 582. NEW YORK: SPRINGER. ISSN 1435-702X

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Abstract

Excimer laser phototherapeutic keratectomy (PTK) is a safe treatment for superficial corneal opacities, e.g., in corneal dystrophies or degenerations. Nevertheless, no standardized treatment protocols are available and intraoperative monitoring was not possible, so far. Here we evaluate the potential benefits of the intraoperative assessment by microscope-integrated intraoperative optical coherence tomography (MI-OCT) of corneal optical properties during PTK. Retrospective study of eight patients (one male, seven females; age range, 43-80 years, mean = 66.1 years) using an 840-nm microscope-integrated spectral-domain OCT (iOCT; OptoMedical Technologies, Luebeck, Germany adapted to HS Hi-R Neo 900A, Haag Streit Surgical, Wedel, Germany). Images were acquired before and after corneal abrasion and after PTK. For PTK, a SCHWIND Amaris 750S excimer laser (SCHWIND eye-tech-solutions GmbH und KO. KG) was used. Parameters assessed were the central corneal thickness (CCT), changes in central depth-dependent corneal tissue intensity (TI), and corneal surface roughness (SR) in cross-sectional images of the cornea. Intraoperative monitoring using microscope-integrated OCT was possible in all patients at all time points. TI of the anterior corneal stroma decreased significantly (p = 0.037) after PTK (T1 = 15.1 +/- 3.6, T2 = 15.0 +/- 3.84, T3 = 13.7 +/- 3.38), but not after corneal abrasion alone, indicating increased transparency caused by excimer laser PTK. CCT was significantly lower after corneal abrasion (p = 0.017), but not after PTK (T1 = 630.4 +/- 70 mu m, T2 = 544.1 +/- 59.4 mu m, T3 = 558.3 +/- 52.5 mu m. SR significantly decreased (p = 0.043) after PTK (T1 = 614.4 +/- 37.5 pixels, T2 = 634.4 +/- 35.6 pixels, T3 = 611.0 +/- 40.3 pixels). Intraoperative OCT allows real-time imaging during PTK and the assessment of corneal optical transparency and its surface roughness. It has to be clarified in larger studies if these parameters correlate with later postoperative visual outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Siebelmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Horstmann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholz, Paula UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED Matthaei, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Hermann, Manuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-194940
DOI:	10.1007/s00417-017-3867-7
Journal or Publication Title:	Graefes Arch. Clin. Exp. Ophthalmol.
Volume:	256
Number:	3
Page Range:	S. 575 - 582
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-702X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RECURRENCE; DYSTROPHY; EROSIONS; SURGERY Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19494