Early changes in host and donor lenticule thickness after Descemet stripping endothelial keratoplasty.

PURPOSE: To analyze the early changes in host and donor lenticule thickness after Descemet Stripping Endothelial Keratoplasty (DSEK). METHODS: DSEK was performed on 32 eyes of 31 patients. Pre- and post- operative slit lamp examination and anterior segment Optical Coherence Tomography (OCT) was done on day-1, day-7, 1 month, and 3 months. RESULTS: There were significant changes in host, lenticule, and total corneal thicknesses between day-1 and day-7, and day-7 and 1 month. There were significant changes in host thickness and total corneal thickness between 1 month and 3 months. Thickness changes were significant between day-1 and day-7, and 1 month and 3 months for thick and thin host, respectively, whereas these changes were observed both for thick and thin host between day-7 and 1 month. Similarly, significant changes were observed between day-7 and 1 month, and day-7 and 1 month in thin lenticule whereas in case of thick lenticule, it was observed till the 3 months follow-up period. There was a significant improvement in visual acuity till the 3 months follow-up period. No significant correlation was observed between visual acuity and host and lenticule thickness. CONCLUSION: The thicknesses of host and lenticule decrease continuously. Lenticule thickness stabilizes before host. Thinner cornea stabilizes earlier compared to thicker cornea.

High-Resolution Anterior Segment Optical Coherence Tomography in Intraepithelial Versus Invasive Ocular Surface Squamous Neoplasia.

PURPOSE: To evaluate the imaging characteristics of intraepithelial and invasive ocular surface squamous neoplasia (OSSN) on high-resolution anterior segment optical coherence tomography (ASOCT). METHODS: In this prospective cross-sectional study, 17 consecutive patients (10 intraepithelial and 7 invasive) with histopathologically proven OSSN were included. All patients underwent slit-lamp imaging and time-domain ASOCT at premarked sites. Management included standard complete surgical excision with margin clearance and cryotherapy for all cases. The correlation between imaging characteristics and histopathology sections at the premarked sites was analyzed to determine surrogate markers that may help differentiate intraepithelial from invasive OSSN. In addition, 3 patients with presumed OSSN underwent serial ASOCT for surveillance. RESULTS: All tumors were staged as T3N0M0 except 2 that were staged as T1N0M0 by the eighth edition of the American Joint Committee on Cancer (AJCC). Mean age was comparable between the 2 groups (56 years vs. 54 years for intraepithelial and invasive groups, respectively, P = 0.79). ASOCT characteristics included all cases (100%) showing a hyperreflective thickened epithelium and abrupt transition between normal and abnormal epithelium. Nine of 10 (90%) intraepithelial OSSN showed a clear plane of separation. A hyperreflective basal membrane was seen in 60% of intraepithelial OSSN, and hyporeflective zones were seen in 57% of invasive OSSN. Mean thickness was 924 and 1662 µm in intraepithelial and invasive OSSN, respectively (P = 0.02, Mann-Whitney test). CONCLUSIONS: A visible clear plane of separation and increased thickness on ASOCT may serve as surrogate markers of intraepithelial OSSN and help differentiate it from invasive OSSN.

Imaging of proximal lacrimal system with time domain anterior segment optical coherence tomography in Asian Indian population.

This article reports proximal lacrimal system parameters using Anterior Segment Optical Coherence Tomography (ASOCT-Visante) in an apparently normal Asian Indian population with assessment of any correlation between tear meniscus height and punctal diameter. This was a prospectively designed observational study that included healthy adults, who volunteered for optical coherence tomography imaging (OCT) of their proximal lacrimal system. Time domain ASOCT (Visante) images of the punctum and proximal canaliculus were captured using the high resolution corneal scan protocol. External lacrimal punctal diameter (ELP), internal lacrimal punctal diameter (ILP), vertical canalicular length (VCL) and tear meniscus height (TMH) were calculated. Statistical analysis was performed using Pearson's correlation test. Our study had 100 normal subjects with mean age 24.14 years, range 15-38 years. ASOCT (Visante) with advantage of deeper penetration was able to image canaliculus in all cases. The mean TMH, ELP, ILP and VCL was 252.7 ± 67.98 µm, 382.2 ± 103.14µm, 140.7 ± 67.29 µm and 811.8 ± 253.7 µm, respectively, in 100 normal subjects. No correlation was found between ELP, ILP and TMH (Pearson's Correlation; r = -0.355, p > 0.05 for all). ASOCT (VisanteTM) is a non-invasive and easy to use objective tool for imaging proximal lacrimal system. Further studies are required to validate normative data and correlate with microscopic findings of lacrimal system.