New insight on cause of post-DSAEK haze

This prospective study found that eyes with transient interface fluid (TIF) on intraoperative OCT are more likely to develop textural interface opacity (TIO) during the postoperative period.

TIO can occur at the graft-host interface after Descemet stripping automated endothelial keratoplasty (DSAEK). This interface haze with diffuse, central, fine, grayish opacities is typically noted early during the postoperative period.

There are various theories about why and how TIO develops. The authors hypothesize that the presence of occult TIF intraoperatively may result in subsequent TIO.

The authors used intraoperative OCT to evaluate 76 eyes from 69 patients who underwent DSAEK. They found that eyes with TIF had a significantly higher rate of postoperative TIO (odds ratio = 47.25, P < 0.0001).

They speculate that the mix of aqueous, balanced salt solution and viscoelastic may contribute to this transient intraoperative interface fluid, and that the precipitates from this mix are ultimately left behind in the graft-host interface. This finding of TIF using intraoperative OCT helps to shed more light on the finding of interface haze postoperatively in DSAEK surgery.