Fine needle diathermy occlusion of corneal vessels.
OBJECTIVE
To evaluate the efficacy of fine needle diathermy (FND) occlusion of corneal vessels in relation to defined clinical indications.


METHODS
A retrospective, consecutive case series including all patients treated by FND for occlusion of corneal vessels between 2004 and 2012. Indications were lipid keratopathy, preparation for keratoplasty to reduce risk of rejection and treatment of recalcitrant corneal graft rejection associated with stromal vessels. Our outcome measures were occlusion of corneal vessels with reduced corneal vascularisation, reduction in amount of lipid deposition, and reduction of graft rejection episodes.


RESULTS
FND effectively reduced lipid deposition associated with the treated vessels in 14 out of 17 eyes (82.3%). When used to reduce corneal vascularisation before keratoplasty and to reduce intraoperative bleeding, the 1-year survival of the high-risk grafts was (84.6%). FND prevented further rejection episodes in 3 out of 4 corneal grafts. Fourteen eyes required retreatment (2-5 times) of which 9 had lipid keratopathy and 5 were in preparation for corneal grafting.


CONCLUSIONS
FND is effective in occluding established corneal vessels. Corneal microperforation is a potentially serious adverse event, but other adverse events, such as striae, whitening and intracorneal haemorrhages are reversible. It should be considered for established corneal vessels, and can be combined with antivascular endothelial growth factors.
Academic Ophthalmology, School of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Lana A
LA
Faraj
Academic Ophthalmology, School of Clinical Neuroscience, University of Nottingham, Nottingham, UK Cornea Unit, Research Institute of Ophthalmology, Cairo, Egypt.
Mohamed S
MS
Elalfy
Academic Ophthalmology, School of Clinical Neuroscience, University of Nottingham, Nottingham, UK Cornea Unit, Research Institute of Ophthalmology, Cairo, Egypt.
Dalia G
DG
Said
Academic Ophthalmology, School of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Harminder S
HS
Dua
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003315:Cornea / Q000378:metabolism; D016510:Corneal Neovascularization / Q000628:therapy*; D016039:Corneal Transplantation; D003972:Diathermy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D009339:Needles; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
Cornea; Neovascularisation; Treatment Surgery