Abstract: Intraoperative optical coherence tomography (iOCT) is an intraoperative navigation microscope system that can be used not only for surgeries such as vitreoretinal, ICL implantation, cataracts, glaucoma, but also for corneal transplantation surgery. In penetrating keratoplasty, the real-time visualization of iOCT helps the surgeon understand the intraocular situation, define the implant bed range, and handle angle adhesions. In lamellar keratoplasty, the depth and uniformity of corneal stroma detachment can be observed to prevent perforation of the posterior elastic layer, timely treatment of interlayer fluid accumulation, and avoid the formation of double anterior chambers. In addition, in corneal endothelial transplantation, iOCT can reveal the position of the graft and its adhesion to the corneal stroma, observe whether the graft is unfolded or inverted, and help the surgeon handle it in a timely manner to improve the success rate of the surgery. (Int Rev Ophthalmol, 2024, 48:  357-363)

Key words: intraoperative optical coherence tomography; , keratoplasty