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Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study.

Publication ,  Journal Article
Pasricha, ND; Shieh, C; Carrasco-Zevallos, OM; Keller, B; Cunefare, D; Mehta, JS; Farsiu, S; Izatt, JA; Toth, CA; Kuo, AN
Published in: Cornea
November 2016

PURPOSE: To examine big-bubble (BB) formation success rates in deep anterior lamellar keratoplasty (DALK) at various corneal depths using real-time guidance from swept-source, microscope-integrated optical coherence tomography (SS-MIOCT). METHODS: The DALK procedure was performed ex vivo with 34 human donor corneoscleral buttons on pressurized artificial anterior chambers using the BB technique employed by Anwar and Teichmann. We inserted a needle under controlled ex vivo conditions to corneal depths ranging from 40% to ≥90% using real-time guidance from SS-MIOCT and injected air. BB success was then determined for each injection. RESULTS: The average needle depth for successful full BB formation was 79.9% ± 3.0% compared with 66.9% ± 2.6% for partial BB formation and 49.9% ± 3.4% for no BB formation (P < 0.0001). Expressed as stroma below the needle tip, this corresponded to 123.9 ± 20.0 μm for successful full BB formation compared with 233.7 ± 23.8 μm for partial BB formation and 316.7 ± 17.3 μm for no BB formation (P < 0.0001). All other variables tested (sex, race, age, endothelial cell density, air injected, needle angle, and central corneal thickness) did not significantly affect BB formation success rates. CONCLUSIONS: BB formation in DALK is more successful if needle insertion and air injection occur at deeper corneal depth. However, ≥90% corneal depth was not necessary in this ex vivo model of DALK. SS-MIOCT can be used to accurately guide the needle in real time.

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Published In

Cornea

DOI

EISSN

1536-4798

Publication Date

November 2016

Volume

35

Issue

11

Start / End Page

1471 / 1477

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Tissue Donors
  • Pregnancy
  • Ophthalmology & Optometry
  • Needles
  • Middle Aged
  • Male
  • Humans
  • Female
  • Endotamponade
 

Citation

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Chicago
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MLA
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Pasricha, N. D., Shieh, C., Carrasco-Zevallos, O. M., Keller, B., Cunefare, D., Mehta, J. S., … Kuo, A. N. (2016). Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study. Cornea, 35(11), 1471–1477. https://doi.org/10.1097/ICO.0000000000000948
Pasricha, Neel D., Christine Shieh, Oscar M. Carrasco-Zevallos, Brenton Keller, David Cunefare, Jodhbir S. Mehta, Sina Farsiu, Joseph A. Izatt, Cynthia A. Toth, and Anthony N. Kuo. “Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study.Cornea 35, no. 11 (November 2016): 1471–77. https://doi.org/10.1097/ICO.0000000000000948.
Pasricha ND, Shieh C, Carrasco-Zevallos OM, Keller B, Cunefare D, Mehta JS, et al. Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study. Cornea. 2016 Nov;35(11):1471–7.
Pasricha, Neel D., et al. “Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study.Cornea, vol. 35, no. 11, Nov. 2016, pp. 1471–77. Pubmed, doi:10.1097/ICO.0000000000000948.
Pasricha ND, Shieh C, Carrasco-Zevallos OM, Keller B, Cunefare D, Mehta JS, Farsiu S, Izatt JA, Toth CA, Kuo AN. Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study. Cornea. 2016 Nov;35(11):1471–1477.

Published In

Cornea

DOI

EISSN

1536-4798

Publication Date

November 2016

Volume

35

Issue

11

Start / End Page

1471 / 1477

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Tissue Donors
  • Pregnancy
  • Ophthalmology & Optometry
  • Needles
  • Middle Aged
  • Male
  • Humans
  • Female
  • Endotamponade