ABSTRACT
@#AIM: To investigate the clinical efficacy of anterior stromal puncture(ASP)for the corneal epithelial cells dysfunction(CED).<p>METHODS: Sixteen patients with CED underwent ASP in Wuhan Union Hospital from September 2015 to December 2015 were included. Uncorrected visual acuity, ocular surface disease index(OSDI), corneal fluorescence staining, corneal epithelial thickness, full corneal thickness, corneal subepithelial dendritic cell density, corneal endothelial cell density and corneal epithelial nerve density were observed and recorded at preoperative, 1mo and 3mo postoperatively, respectively.<p>RESULTS: Totally 16 patients compared with preoperatively, there was a significant increase in uncorrected visual acuity and corneal epithelial nerve density(<i>P</i><0.05)or a significant decrease in OSDI, corneal fluorescence staining, corneal epithelial thickness, full corneal thickness and corneal subepithelial dendritic cell density(<i>P</i><0.05)at 1mo postoperatively; while there was no significant difference in corneal endothelial cell density(<i>P</i>>0.05). And compared with 1mo postoperatively, there was a significant decrease in corneal subepithelial dendritic cell density(<i>P</i><0.05)and a significant increase in corneal epithelial nerve density(<i>P</i><0.05)at 3mo postoperatively, while there was no significant difference in uncorrected visual acuity, OSDI, corneal fluorescence staining, corneal epithelial thickness, full corneal thickness and corneal endothelial cell density(<i>P</i>>0.05).<p>CONCLUSION: ASP was effective for CED. Corneal confocal microscopy was essential for the evaluation of ASP efficacy, which can guide the clinical work better and establish the termination of intervention.
ABSTRACT
PURPOSE: The purpose of this study is to evaluate the efficacy of the combined treatment of anterior stromal puncture with the concurrent use of 5% NaCl eye drops for 6 months for recurrent corneal erosion syndrome. METHODS: A retrospective chart review was conducted for 21 patients (21 eyes) who underwent the combined treatment of anterior stromal puncture with 5% NaCl eye drops qid for 6 months to treat recurrent corneal erosion syndromes. The patients' age, gender, history of corneal trauma, history of ocular surgery, recurrence rate, need for additional treatments after recurrence and complication were analyzed. RESULTS: The mean age was 42.05 ± 13.83 years (19-68 years) with no significant difference in gender, and the mean follow up period was 8.48 ± 2.76 months (6-15 months). Among the 21 eyes 14 eyes (66.7%) had a previous history of corneal trauma, 2 eyes (9.52%) had previous refractive surgery, 1 eye (4.8%) had corneal dystrophy, 2 eyes (9.5%) had diabetic mellitus and 5 eyes (28.81%) had an unknown origin. Furthermore, 3 eyes (14.3%) developed recurrences and 2 eyes were resolved with conservative treatment while 1 eye needed additional anterior stroma puncture. There was no recurrence after retreatment with anterior stroma puncture. No significant complications such as infection or inflammation developed with the exception of corneal opacity in which one patient developed glare due to corneal opacity. CONCLUSIONS: The combined treatment of anterior stromal puncture with 5% NaCl eye drops for a prolonged time might be effective at preventing the recurrence of refractory recurrent corneal erosion syndrome with conservative treatments.
Subject(s)
Humans , Corneal Injuries , Corneal Opacity , Follow-Up Studies , Glare , Inflammation , Ophthalmic Solutions , Punctures , Recurrence , Refractive Surgical Procedures , Retreatment , Retrospective StudiesABSTRACT
Introduction: Toric intraocular lenses (IOLs) are an effective way of compensating preexisting corneal astigmatism during cataract surgery. To achieve success, it is imperative to align the toric IOLs in desired position and preoperative reference marking is one among the three important steps for accurate alignment. To make the marking procedure simpler and effective, we have modified the conventional three‑step slit lamp‑based technique. Materials and Methods: Patient is seated in front of the slit lamp and asked to keep the chin over chin rest. A 26‑gauge bent needle with tip stained by sterile blue ink marker is used to make anterior stromal puncture (ASP) at the edges of horizontal 180° axis near the limbus. Results: A total of 58 eyes were retrospectively evaluated. Mean (+/-SD) IOL deviation on day 1 and day 30 was 5.7 ± 6.5° and 4.7 ± 5.6°, respectively. Median IOL misalignment on day 1 and day 30 was 3°. Redialing of IOL was required in 2 (3.4%) eyes only, all of which were performed within 1 week of surgery. In total, 2 (3.7%) eyes had a residual astigmatism of − 0.5 Dcyl and − 1.0 Dcyl, respectively. Conclusion: ASP is an effective technique for reference marking, technically simpler and can be practiced by most of the surgeons. It avoids the necessity of high‑end sophisticated machinery and gives a better platform for the reference corneal marking along with the benefit of reproducibility and simplicity.
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PURPOSE: To evaluate the clinical results of anterior stromal puncture (ASP) using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for refractory recurrent corneal erosion (RCE). METHODS: Ten eyes of eight patients with RCE showing poor response to conservative therapy who were treated with Nd:YAG laser ASP and followed up for at least 4 months were studied. The cause and duration of erosions, times, and total energy of the laser were recorded. The preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, complications, and recurrence were reviewed. RESULTS: The mean follow-up time was 9.6 months. The laser energy setting was 0.2 or 0.3 mJ per shot. The average total laser energy was 6.2 mJ. Two of 10 eyes received another Nd:YAG laser treatment. All 10 eyes were successfully treated and had no recurrence after the operation during follow-up. Postoperative BCVAs were equal to or better than the preoperative BCVAs. No significant complications except faint corneal haze were observed. CONCLUSIONS: Nd:YAG laser ASP is an effective and safe procedure to treat refractory RCE in short-term follow-up.
Subject(s)
Humans , Follow-Up Studies , Intraocular Pressure , Punctures , Recurrence , Viperidae , Visual AcuityABSTRACT
PURPOSE: Recurrent corneal erosion (RCE) is a highly recurrent and intractable disease. None of the available conventional treatments has been shown to be specifically efficacious for RCE. Recently, many new methods were actively studied and used for RCE such as epithelial basement membranectomy, excimer laser therapeutic keratectomy, and anterior stromal puncture. We report 5 cases of RCE successfully cured using anterior stromal puncture with disposable 26-gauge needle. METHODS: A total of 5 eyes from 5 RCE patients, who had been initially treated with conventional therapy but suffered from recurrence, were treated using anterior stromal puncture with disposable 26-gauge needle from January 1999 to October 2001. We investigated the efficacy of this method over conventional therapy by retrospective review of their medical records. RESULTS: The average trial number per patient was 1.2 (once or twice). There was no recurrence of RCE in 5 patients after the final trial. CONCLUSIONS: We have shown that anterior stromal puncture with disposable 26-gage needle is a better method over conventional methods to cure RCE caused by trauma and epithelial basement membrane dystrophy.
Subject(s)
Humans , Basement Membrane , Lasers, Excimer , Medical Records , Needles , Punctures , Recurrence , Retrospective StudiesABSTRACT
Many conventional treatments of recurrent corneal erosion have been reported to yield varying degrees of effect. Epithelial basement menmbranectomy, microdiathermy or needle anterior stromal puncture, and excimer laser phototherapeutic keratectomy have recently been proposed as new treatments for recalcitrant cases of recurrent corneal erosion. We used the Nd:YAG laser to perform anterior stromal puncture of evaluation of therapeutic effects and several advantages effects over conventional treatments. For this purpose, we performed retrospective review of medical records of 7 patients who had been confirmed to have recurrent corneal erosion and given a trial of the Nd:YAG laser anterior stromal puncture due to two or more recurrences in spite of conventional treatments from January 1996 to December 1997. The mean recurrence rate of erosion before anterior stromal puncture and the mean trial number were 1 time(ranging from 1 to 2 times) per month and 4.7 times(ranging from 1 to 10 times), respectively. There were no recurrences after the laser trial in all 7 patients. Compared with various conventional treatments, this study showed the Nd:YAG laser anterior stromal puncture may obtain more permanent healing in mild to moderate epithelial basement membrane dystrophy and traumatic recurrent corneal erosion.
Subject(s)
Humans , Basement Membrane , Lasers, Excimer , Medical Records , Needles , Punctures , Recurrence , Retrospective StudiesABSTRACT
Many conventional treatments of recurrent corneal erosion have been reported to yield varying degrees of effect. Epithelial basement menmbranectomy, microdiathermy or needle anterior stromal puncture, and excimer laser phototherapeutic keratectomy have recently been proposed as new treatments for recalcitrant cases of recurrent corneal erosion. We used the Nd:YAG laser to perform anterior stromal puncture of evaluation of therapeutic effects and several advantages effects over conventional treatments. For this purpose, we performed retrospective review of medical records of 7 patients who had been confirmed to have recurrent corneal erosion and given a trial of the Nd:YAG laser anterior stromal puncture due to two or more recurrences in spite of conventional treatments from January 1996 to December 1997. The mean recurrence rate of erosion before anterior stromal puncture and the mean trial number were 1 time(ranging from 1 to 2 times) per month and 4.7 times(ranging from 1 to 10 times), respectively. There were no recurrences after the laser trial in all 7 patients. Compared with various conventional treatments, this study showed the Nd:YAG laser anterior stromal puncture may obtain more permanent healing in mild to moderate epithelial basement membrane dystrophy and traumatic recurrent corneal erosion.