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Epithelial In-growth

Epithelial in-growth after IntraLase Enabled Lamellar Keratoplasty

 

This is a case of a patient with history of hard contact lens with a central corneal ulcer and resultant scar.  His case presentation is under IntraLase Lamellar Keratoplasty page.  At 19 months post op, a moderate size epithelial in-growth is noted and evaluated by the technologies of the Visante, and the Cirrus OCT. 

The clinical images is presented on the side for reference as the different technologies show case their capabilities.

 

  

Visante Anterior Segment OCT image of an Epithelial ingrowth after IntraLase Enabled Lamellar Keratoplasty

The Visante OCT image of the above case is presented in the enhanced High Res image with is 10mm by 3mm.  The items to note are that the interface of the graft and the native cornea is clearly noted similar to post LASIK patients.  The flap tools can be used to measure the flap thickness and the residual stomal bed (not presented here).  The epithelial in-growth is noted and can be easily measured with calipers (note presented here).  The 1310nm technology allows for the light to pass through the epithelial ingrowth and visualize the tissue posterior to the growth.

Cirrus OCT image of an epithelial ingrowth after IntraLase Enabled Lamellar Keratoplasty

In the above image from the Cirrus OCT where 840nm light source is used, the tissue anterior the epithelial ingrowth is exquisitely clear.  The epithelium, the Bowman's membrane and the detail of the in-growth is amazing.  Yet, the tissue behind the epithelial ingrowth is clearly not visible as the 840nm light does not penetrate beyond the ingrowth.

Cirrus OCT image of a cornea after IntraLase Enabled Lamellar Keratoplasty

The Cirrus OCT image taken from the very center of the cornea shows the epithelium, the Bowman's layer, the anterior corneal graft, the interface with mild residual stromal scar and the posterior lamellae of native corneal tissue.