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Fine Needle Diathermy Occlusion of Corneal Vessels

From the Division of Ophthalmology, University of Nottingham, Queens Medical Centre, Nottingham, England.

PURPOSE. To develop a novel technique, fine needle diathermy (FND), for the occlusion of corneal vessels and to evaluate its safety and efficacy in a series of patients.

METHODS. Fourteen patients were treated with FND to occlude corneal vessels. Patients were categorized into four groups: group 1 (n = 4), high risk patients with stromal vascularization before keratoplasty; group 2 (n = 2), patients with progressive lipid keratopathy; group 3 (n = 4), post keratoplasty patients with active rejection episodes associated with vessels; and group 4 (n = 4), patients with disciform vascularized scars with recurrent inflammation. The success of the treatment in terms of vessel occlusion and the clinical outcome were monitored.

RESULTS. All patients in group 1 had successful corneal transplantation, and the grafts remained clear without graft rejection. Patients in group 2 with lipid keratopathy had 100% obliteration of vessels with stabilization of corneal scar. All four patients in group 3 had complete regression of vessels with reversal of graft rejection. Patients with vascularized disciform scar had resolution of the inflammation without recurrence. Average follow-up was 10.3 months (minimum, 6 months; maximum, 24 months). No serious complications were observed with FND.

CONCLUSIONS. FND is a useful and inexpensive technique that can serve as an adjunct or alternative to laser occlusion for the treatment of established corneal vessels. It is fairly safe and effective, although complications such as intrastromal bleeding and crystalline deposits can occur and at times it may have to be repeated once or twice to achieve the desired result.

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