Long-Term Monitoring of Corneal Grafts Via Anterior Segment OCT Pachymetry Maps

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-01-31 DOI:10.1016/j.xops.2025.100724

Anastasia Neokleous MD, MSc , Neofytos Michail MD , Fedonas Herodotou MD , Aikaterini Athanasiadou MSc , Stylianos Christodoulou MD, MSc , Dimitris Kola MD , Klea Panayidou PhD , Georgina Hadjilouka MD, PhD , Sotiria Palioura MD, PhD

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Abstract

Purpose

To assess the efficacy of anterior segment OCT (AS-OCT) in the long-term monitoring of corneal grafts and its integration into a hybrid remote care model for early detection and management of graft rejection or failure.

Design

Prospective cohort study.

Participants

Seventy-four patients (93 eyes) who underwent corneal transplantation from October 2021 to December 2023, with a follow-up period of ≥6 months.

Methods

Serial AS-OCT pachymetry maps and cross-sectional scans were performed at fixed postoperative intervals, and the findings were correlated with clinical signs of graft rejection or failure on slit lamp examination for thickness changes >50 μm. A hybrid remote AS-OCT screening protocol was initiated 1 week postoperatively.

Main Outcome Measures

Diagnostic accuracy of AS-OCT, measured by specificity and sensitivity, in detecting graft rejection or failure through changes in corneal and graft thickness.

Results

Anterior segment OCT demonstrated high diagnostic accuracy with a specificity of 97.6% and a sensitivity of 88.9% in detecting graft rejection or failure. The mean central corneal thickness increase in cases resulting in graft rejection or failure was 82.7 ± 21.5 μm, a thickness change that is not discernible by slit lamp examination alone. The utility of AS-OCT in a hybrid remote monitoring model was demonstrated through 3 detailed case studies, highlighting improved clinical workflow and patient convenience without compromising postoperative outcomes.

Conclusions

Serial AS-OCT imaging serves as a robust, objective, and quantitative tool for postoperative surveillance of corneal grafts, significantly benefiting patient outcomes by allowing timely interventions. Integration of AS-OCT into a hybrid remote screening protocol supports comprehensive monitoring, complementing direct clinical evaluations and optimizing postoperative care.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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通过前段OCT厚测图长期监测角膜移植物

目的评价前段OCT （AS-OCT）长期监测角膜移植的疗效，并将其纳入混合远程护理模式，用于早期发现和处理移植排斥或失败。前瞻性队列研究。参与者：在2021年10月至2023年12月期间接受角膜移植的74例患者（93只眼），随访期≥6个月。方法术后固定时间间隔进行连续AS-OCT厚测图和横断面扫描，观察厚度变化≥50 μm时，观察结果与移植排斥或失败的临床体征相关。术后1周采用混合远程AS-OCT筛查方案。AS-OCT的诊断准确性，通过特异性和敏感性来衡量，通过角膜和移植物厚度的变化来检测移植排斥或失败。结果前段OCT诊断排斥或移植失败的特异性为97.6%，敏感性为88.9%。导致移植排斥或失败的患者角膜中央厚度平均增加82.7±21.5 μm，仅通过裂隙灯检查无法发现这种厚度变化。通过3个详细的案例研究证明了AS-OCT在混合远程监测模型中的应用，强调了在不影响术后结果的情况下改善临床工作流程和患者便利性。连续as - oct成像是角膜移植术后监测的一种可靠、客观、定量的工具，通过及时干预，显著改善了患者的预后。将AS-OCT集成到混合远程筛查方案中，支持全面监测，补充直接临床评估并优化术后护理。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

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