Posters
Intracameral 5-fluorouracil and viscous dispersive viscoelastic for diffuse epithelial downgrowth management in aphakia
Poster Details
First Author: S.Montolío-Marzo SPAIN
Co Author(s): E. Fernández-López J. Piá-Ludeña J. Davo-Cabrera E. Alfonso-Muñoz C. Peris-Martínez
Abstract Details
Purpose:
Epithelial downgrowth is an extremely rare and sight-threatening complication. Little evidence is available regarding to treatment choices and outcomes. Aphakic patients are specially challenging due to the absence of anatomical limits. We want to report the use of a combination of 5-fluorouracil and DiscoVisc for locating the treatment in the posterior cornea thus avoiding drug dispersion and potential adverse effects in aphakic patients
Setting:
FISABIO Oftalmología Médica, Valencia, Spain
Methods:
A retrocorneal pigment line and corneal edema refractory to steroids appeared in a single-eyed aphakic patient with history of multiple surgeries and previous keratoplasty. Due to its progression and the hyperreflective posterior line in the anterior segment optical coherence tomography, the diagnosis of epithelial downgrowth was considered. It was treated injecting a combination of intracameral 5-fluorouracil 1,000 microg/0.1ml DiscoVisc.
Results:
The choice of a DiscoVisc, combining cohesive and dispersive properties, enabled localizing the mixture facing the posterior cornea and also facilitating a quick clearance of the drug if needed due to intraoperative posterior migration. After two injections, the lesion disappeared and the patient is now awaiting a new keratoplasty due to secondary corneal failure. The chosen dose of 5-FU showed to be effective with sequential application. Properties of DiscoVisc used optimized treatment and limited secondary effects to the anterior segment with no posterior chamber involvement.
Conclusions:
Intracameral 5-fluorouracil may be a good therapeutic option for diffuse epithelial downgrowth. Adding a viscous dispersive mixture limit the effect of the treatment in the retrocorneal area in aphakic patients and improves the safety of the treatment.
Financial Disclosure:
None
