Anterior segment OCT in corneal diseases and surgery

• Published in: Acta ophthalmologica (Oxford, England) England), 2016-10, Vol.94 (S256), p.n/a
• Main Authors: Nubile, M., Calienno, R., Salgari, N., De Nicola, C., Lappa, A., Mastropasqua, A.
• Format: Article
• Language: English
• Subjects: Adhesion tests; Angiography; Cornea; Corneal transplantation; Eye diseases; Eye surgery; Flaps; Interfaces; Literature reviews; Medical imaging; Morphometry; Ophthalmology; Optical Coherence Tomography; Retina; Surgery; Thinning; Tomography; Transparency
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2016.0223

Summary Purpose Optical coherence tomography (OCT) after extended use in diagnosis of retinal diseases has now become a new cross‐sectional imaging approach useful for anterior segment (AS) imaging. The potential advantages and limits using AS‐OCT in corneal diseases and surgery are presented. Methods Systematic literature review search and clinical examples focused in the fields of corneal ulcerations, opacities and corneal graft penetrating and lamellar surgery. Results AS‐OCT provides accurate morphology and measurements of different structures of the AS and of the cornea. Corneal loss of transparency in general permits visualization of the deeper AS structures facilitating surgical choice in complex cases. In contrast ciliary bodies are barely visualized, in contrast to UBM, due to light absorption by pigmented iris layers. Morphometry of corneal structures is particularly useful in the preoperative evaluation of thinning disorders, corneal ulcerations, infections and loss of transparency and after penetrating and lamellar surgery, including assessment of LASIK flaps and of deep anterior keratoplasty interfaces and endothelial keratoplasty lenticules adhesion. New generation optical coherence tomography angiography (OCTA) system for the assessment of corneal neovascularisation may be useful to evaluate ocular surface and corneal diseases in which the growth of vessels plays a role in the history and management of pathology. Conclusions AS‐OCT presents advantages in the clinical practice in the field of corneal disease and surgery. This technology alone should not substitute a comprehensive clinical examination but may offer valuable insights in the quantification and observation of fine details which can be obscured or not detectable during conventional slit‐lamp examination.