Anterior Segment Optical Coherence Tomography in Descemet

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Anterior Segment Optical Coherence Tomography in
Descemets Membrane Detachment After Cataract
Surgery

• Wylegala Edward, Nowinska Anna

Nursing Dept. and Social Medical Issues, Health
Care Division, Silesian Medical University,
Katowice, Poland
Head
Edward Wylegala, MD, PhD Dept. of Ophthalmology,
District Railway Hospital, Katowice, Poland
Head Edward Wylegala, MD, PhD
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PURPOSE

• To evaluate the usefulness of the anterior
  chamber optical coherence tomography (VisanteTM
  OCT ) in diagnosis and monitoring the results of
  treatment of Descemets membrane detachment after
  cataract surgery

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Material and methods

• 8 eyes of 8 patients with Descemets membrane
  detachment from 2005 to 2007
  
  phacoemulsification cataract surgery (3,0 or 3,2
  mm incision)

Additional slit lamp findings number of eyes
Fuchs endothelial dystrophy 1
pseudoexfoliation syndrome 1
angle-closure glaucoma 2
confirm or make the diagnosis
evaluate the
configuration of detachment
monitor treatment results
OCT
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Results
Diagnosis of Descemets membrane detachment
CONFIGURATION BASED ON OCT CONFIGURATION BASED ON OCT CONFIGURATION BASED ON OCT CONFIGURATION BASED ON OCT
eye days to diagnosis visual acuity CCT (µm) planar nonplanar with scrolling without scrolling
1 1 20/2000 876 ? ?
2 1 20/1000 823 ? ?
3 1 20/60 598 ? ?
4 1 20/100 647 ? ?
5 3 20/2000 923 ? ?
6 2 20/2000 911 ? ?
7 1 20/80 615 ? ?
8 5 20/1000 850 ? ?
CCT central corneal thickness
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Results
Configuration of detachment based on OCT
examination
localized planar
exstensive nonplanar
exstensive nonplanar with scrolling
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Results
Treatment method and outcome
Eye Visual acuity Detachment configuration CCT (µm) First treatment Second treatment Final CCT (µm) Final visual acuity
1 20/2000 nonpl 876 air tamp air tamp corneal inc. 589 20/50
2 20/1000 pl 823 cons. air tamp. 567 20/40
3 20/60 pl 598 cons. 534 20/20
4 20/100 pl 647 cons. 524 20/20
5 20/2000 nonpl 923 air tamp 546 20/60
6 20/2000 nonpl 911 air tamp 566 20/32
7 20/80 pl 615 cons. 523 20/20
8 20/1000 planar 850 cons air tamp 576 20/40
pl planar, nonpl nonplanar, cons.
conservative, air tamp. air tamponade, corneal
incs corneal incision, CCT central corneal
thickness
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Results
Treatment method
5 NaCl, 0,1 Dexamethasone,
1 Tropicamid, ofloxacin
anterior chamber tamponade 1 ml filtered air
topical anesthesia
air tamponade
ab externo stab
incision
in the mid-peripheral area
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Results
monitoring the outcome
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Conclusions

• OCT is very useful in diagnosis and monitoring
  treatment results of Descemets membrane
  detachment
• Decisions regarding treatment should be based on
  the individual features and evaluation of the
  configuration of the detachment using OCT