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OPHTHALMIC IMAGE
Year : 2022  |  Volume : 2  |  Issue : 2  |  Page : 608

Fine needle diathermy for reducing corneal vascularization prior to high-risk corneal grafts


Department of Cornea and Refractive Surgery, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India

Date of Web Publication13-Apr-2022

Correspondence Address:
Radhika Natarajan
Sankara Nethralaya, Medical Research Foundation, 41, College Road, Chennai - 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1824_21

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How to cite this article:
Ravichandran S, Natarajan R. Fine needle diathermy for reducing corneal vascularization prior to high-risk corneal grafts. Indian J Ophthalmol Case Rep 2022;2:608

How to cite this URL:
Ravichandran S, Natarajan R. Fine needle diathermy for reducing corneal vascularization prior to high-risk corneal grafts. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Jun 29];2:608. Available from: https://www.ijoreports.in/text.asp?2022/2/2/608/342904



Fine-needle diathermy (FND) is used to occlude corneal neovascularization before penetrating keratoplasty in high-risk grafts such as healed viral keratitis [Figure 1]a, lipid keratopathy, and failed graft with stromal vessels.[1],[2] Monopolar cautery is applied over a needle directed parallel to large vessels and perpendicular to tufts of smaller vessels, minding the depth. Coagulation of corneal collagen occludes discreet vessels, which can happen quickly over an existing scar. Transient whitening, intracorneal hemorrhages, and striae [Figure 1]b are reversible [Figure 1]c. Keratoplasty is best planned at 3–4 months [Figure 1]d before re-canalization occurs.[3] FND is an inexpensive technique, used alone or as adjunct for angio-regression to enhance corneal graft survival.[4]
Figure 1: Composite picture showing (a) healed viral keratitis with corneal neovascularization; (b) whitening during FND; (c) regression of vessels at 3 months follow-up; (d) penetrating keratoplasty at 4 months following FND under prophylactic dose of oral acyclovir cover

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Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Thatte S. Fine needle diathermy-A choice for managing corneal vascularization. Nepal J Ophthalmol 2011;3:23-6.  Back to cited text no. 1
    
2.
Faraj LA, Elalfy MS, Said DG, Dua HS. Fine needle diathermy occlusion of corneal vessels. Br J Ophthalmol 2014;98:1287-90.  Back to cited text no. 2
    
3.
Spiteri N, Romano V, Zheng Y, Yadav S, Dwivedi R, Chen J, et al. Corneal angiography for guiding and evaluating fine-needle diathermy treatment of corneal neovascularization. Ophthalmology 2015;122:1079-84.  Back to cited text no. 3
    
4.
Pillai CT, Dua HS, Hossain P. Fine needle diathermy occlusion of corneal vessels. Invest Ophthalmol Vis Sci 2000;41:2148-53.  Back to cited text no. 4
    


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