J Korean Ophthalmol Soc.  2015 Mar;56(3):331-338. 10.3341/jkos.2015.56.3.331.

Evaluation of Anterior Stromal Puncture Using Nd:YAG Laser for Refractory Recurrent Corneal Erosion

• Kim SY
• Ko BY

• KMID: 2339037
• DOI: http://doi.org/10.3341/jkos.2015.56.3.331

Abstract

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.

Keyword

Anterior stromal puncture; Nd:YAG laser; Recurrent corneal erosion

MeSH Terms

Follow-Up Studies
Humans
Intraocular Pressure
Punctures*
Recurrence
Viperidae
Visual Acuity

Figure

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  Figure 1. Slit lamp photographs of case 1. (A, B) Before Nd:YAG laser anterior stromal puncture, the loose corneal epithelium was noted. (C, D) Two weeks after the treatment, faint subepithelial opacity was shown. (E, F) Six months after the treatment, the photographs showed that the previous opacity could hardly be detected. Nd:YAG = neodymium:yttrium-aluminum-garnet.

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  Figure 2. Corneal specular microscopic findings of case 10. (A) Findings before Nd:YAG laser anterior stromal puncture. (B) One year after the treatment, there were no specific interval changes in cell density, pleomorphism, and hexagonality. Nd:YAG = neodymium:yttrium-aluminum-garnet.

Reference

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