Posters

Peripheral intrastromal hydration facilitates a safe, deep trephination in corneas of irregular thickness

Poster Details

First Author: L.Furiosi ITALY

Co Author(s): G. Galante   A. Friehmann   J. Myerscough   E. Franco   C. Bovone   M. Busin     

Abstract Details

Purpose:

To evaluate to feasibility of regularizing the peripheral corneal thickness before a deep trephination in highly irregular corneas undergoing deep anterior lamellar keratoplasty (DALK) by means of intrastromal hydration with saline.

Setting:

Villa Igea; Hospital (Forlì, Italy).

Methods:

Interventional case series including all eyes with irregular peripheral corneal thickness undergoing DALK for any indication between January 1 st 2016 and January 1 st 2017 at a single tertiary centre in Forli, Italy. Before trephination, 1mL of normal saline was injected intrastromally into each clock hour of peripheral thinning (determined using preoperative pachymetry) using a 30-guage needle. A deep trephination of 4-450 microns was then performed and DALK was completed as per our previously described technique. Primary outcome measures were perforation during trephination and intraoperative complications, with secondary outcomes of best corrected visual acuityand refraction.

Results:

Peripheral intrastromal hydration was performed in 61 eyes of 61 patients. Intrastromal hydration ensured a safe trephination without perforation into the anterior chamber in 59/61 eyes. In the two cases in which perforation occurred, the perforation site was sutured with a full thickness suture and the surgery was completed successfully. No cases required conversion to penetrating keratoplasty. Intrastromal injection of 1mL of normal saline resulted in an increase in corneal thickness of 31%. After surgery, double anterior chamber was observed in 3 cases (4.9%); with all cases being managed successfully by air injection into the anterior chamber.

Conclusions:

Zonal peripheral intrastromal hydration is a feasible technique to enable safe, deep trephination even in corneas of highly irregular thickness.

Financial Disclosure:

None