Advances in imaging of the OOKP lamina

Purpose The anatomical integrity of an eye bearing an OOKP depends on the integrity and dimensions of the OOKP lamina itself. The lamina is anchored onto the corneo‐scleral envelope initially through suturing. Later on, the overlying buccal mucous membrane graft adheres onto the soft tissues invested into the bone of the lamina, retaining it and providing a seal to guard against entry of microbes into the eye. The integrity and dimensions of the lamina is ascertained clinically at each hospital visit, and this is aided by periodic radiological imaging. Methods We studied the relative merits of volumetric analysis, multislice CT vs Aquilion, and texture analysis. We also studied the feasibility of inserting radioopaque markers into the optical cylinder to aid inter examination orientation thus allowing subtraction radiology. Results Volumetric analysis has proven useful but cannot detect fractures in the lamina. The Aquilion provides slightly superior images but its major advantages are speed of acquisition and a much lower radiation dosage, allowing more frequent examination in cases where there is a suspicion of rapid dissolution of the lamina. Asymmetric markers placed with an optical cylinder can be imaged successfully. Conclusion Much work remains to be done to improve imaging of the OOKP lamina. Consideratons include image resolution, speed of acquisition, radiation dosage, costs, and repeatibility.