Anterior segment optical coherence tomography (AS-OCT) is a valuable tool in corneal transplantation surgery. In deep anterior lamellar keratoplasty (DALK), AS-OCT gives valuable information on preoperative decision process. AS-OCT image of the recipient cornea helps the surgeon to decide whether to proceed with a big bubble DALK or a manual dissection. Preoperative AS-OCT imaging of recipient stroma can also predict Descemet membrane perforation during big bubble induction. Intraoperative AS-OCT assures reaching the proper depth in order, and postoperatively, a surgeon can objectively assess the Descemet membrane and donor association and define complications such as a double anterior chamber. Before deciding for a Descemet membrane endothelial keratoplasty (DMEK), preoperative stromal scars can be identified with an AS-OCT and might affect the decision of the surgical procedure (DMEK or penetrating keratoplasty). After DMEK, graft detachment can be visualized by AS-OCT and treated accordingly.
Part of the book: OCT