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Farin Rajmohmad Shaikh, Praful Kumar Maharana, Jeewan S Titiyal; iOCT (Intra-operative Optical Coherence Tomography) Guided Stromal Fluid Drainage for Corneal Hydrops. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1346.
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Corneal hydrops with multiple stromal clefts and large area of descemet membrane detachment commands long duration for spontaneous resolution. We describe a new technique of iOCT guided stromal fluid drainage for corneal hydrops.
3 patients of keratoconus with acute corneal hydrops with multiple stromal fluid clefts underwent the procedure. All cases had received medical management previously for 3-4 weeks without significant improvement. The technique comprises of iOCT guided multiple venting incision into the stromal fluid pockets with simultaneous air tamponade in the anterior chamber. The time taken for resolution of corneal edema (on ASOCT), requirement of a repeat procedure and any complications arising out of the procedure were noted.
3 patients (age range: 19-21 years) underwent the procedure successfully. All patients were cases of bilateral keratoconus with duration of symptoms between 3-4 weeks. First case resolved within one week while the other two cases resolved within two weeks. In none of the cases repeat procedure was required. Also, none of the cases reported postoperative rise in intra-ocular pressure.
iOCT guided drainage of stromal fluid pockets in cases of corneal hydrops is a safe and effective technique especially in cases with large fluid clefts where medical management alone delays the resolution. Real time monitoring with iOCT for instrument depth and fluid clefts aids in complete and safe drainage of stromal fluid pockets.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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