Safety and efficacy of frequency-doubled Nd-YAG laser photocoagulation of different types of corneal neovascularisation (NLPC): a prospective study

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PURPOSE: Frequency doubling of neodymium-doped yttrium aluminum garnet (Nd-YAG) laser results in emission of photocoagulating 532 nm light compared with photolytic 1064 nm emission. The ergonomic benefits of solid-state lasers led to replacement of older coagulating lasers in ophthalmic centres by frequency-doubled Nd-YAG laser. Our study aims to evaluate safety and efficacy of frequency-doubled Nd-YAG laser for photocoagulation of corneal neovascularisation (NLPC). METHODS: 30 quiet eyes of 28 patients with superficial, mid-stromal and deep stromal inactive corneal neovascularisation were subjected to laser photocoagulation. Resolution of vessels, procedural complications and survival of subsequent corneal grafts were monitored for 3 months. Anterior segment fluorescein angiography (AS-FA) was performed in six eyes to confirm the cessation of blood flow. RESULTS: 20 eyes (66.66%) had complete resolution of neovascularisation. 13 cases of superficial (92.86%) and 6 cases of mid-stromal neovascularisation (75%) showed significant resolution, compared with 1 case of deep neovascularisation (12.5%). Minimal corneal burn (n=4, 13.33%), iris holes (n=3, 10%), anterior chamber bubbles (n=5, 16.67%), self-resolving intrastromal bleed (n=2, 6.67%) and graft-host junctional wound leak (n=1 of 12 keratoplasty cases, 8.33%) were noted. CONCLUSION: NLPC may especially be useful in the eyes with a large vessel arborising within stroma. Lack of comparison with other treatment options leading to inflated safety and efficacy profile of NLPC is the major limitation of this study.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.