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Amna ALMAAZMI, Dalia Said, Marco Messina, dua harminder; Anatomy of Corneal Perforations determined by Anterior Segment Optical coherence tomography (ASOCT). Invest. Ophthalmol. Vis. Sci. 2019;60(9):2143.
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The aim of this study was to examine by ASOCT the anatomy of non-traumatic corneal perforations to ascertain difference between perforation with shallow/collapsed anterior chamber (AC) and those with the AC maintained.
Thirteen eyes of 12 patients, 8 females and 4 males, with average age 79 (+/- 9) who had corneal non-traumatic corneal perforations and cyanoacrylate gluing, from January 2016 to July 2018 were included. All patients had ASOCT using the Spectralis (Heidelberg Engineering GmbH, Heidelberg, Germany) anterior segment module for high resolution scans at multiple time points. A retrospective analysis of over 1000 ASOCT sections, and anterior segment photographs (Topcon SL-D301, Slit-lamp) was conducted by two independent observers. The findings were correlated with clinical features and diagnoses.
All patients had document Seidel’s positive sign at the outset. Seven eyes (53.9%) clinically had “formed” AC (Group 1) and the remaining six eyes (46.1%) showed “flat” AC (Group 2). In group 1 there was hydration of the corneal stroma with pockets of fluid. There was lamellar separation of the stroma with an indirect communication between AC and the exterior. In group 2, the corneal hydration was similar but there was a direct communication of the AC with the exterior. After gluing, the stromal hydration resolved and stroma and epithelial healing occurred beneath the glue. The glue consistently cast a dense shadow posteriorly on ASOCT.Table 1: Different pathologies associated with corneal perforationsDiagnosisNumber of eyesCorneal ulcer secondary to microbial keratitis6Sjogren’s dry eye disease1Rheumatoid Arthritis4Ocular Cicatricial Pemphigoid1Chemical injury1Total13
ASOCT demonstrates that a direct communication between AC and the exterior is associated with shallow or collapsed AC while a valvular communication maintains the AC despite the continuous leak of aqueous. The distinction between direct and valvular
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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