Scleral Lens Application for Preventing Corneal Edema During Vitrectomy

Jeong, Hyun Chul; Jung, Woo Jin

Abstract

PURPOSE
To analyze the effect of scleral lens application for preventing corneal edema during vitrectomy on postoperative corneal status using anterior segment OCT (RTVue 100, Optovue, Fremont, CA, USA).
METHODS
The medical records of 42 eyes (42 patients) who underwent total vitrectomy with no appreciable corneal disease between November 2014 and June 2015 were retrospectively reviewed. Evaluations were performed at 1 day, 1 week, and 1 month after total vitrectomy. Corneal status was noted at every follow-up visit using anterior segment OCT. An analysis was performed to define the changes in corneal status in association with scleral lens application during the surgery.
RESULTS
18 of 42 eyes were treated with a scleral lens during total vitrectomy. The corneal thickness increased after vitrectomy in all cases. The mean corneal thickness increment was 23.9 ± 9.7 µm in the scleral lens group and 43.0 ± 19.5 µm in the non-scleral lens group at 1 day after vitrectomy (p < 0.001). At 1 week after vitrectomy, the mean corneal thickness increment was 8.1 ± 7.2 µm in the scleral lens group and 32.3 ± 19.2 µm in the non-scleral lens group (p < 0.001). The difference in superficial punctate keratitis grade between the two groups was not statistically significant.
CONCLUSION
Scleral lens application during vitrectomy seems to prevent postoperative corneal edema. More cases and a longer period of study is needed to draw definitive conclusions.