Anterior Segment Optical Coherence Tomography In Corneal Perforation
Published 2023 - 41st Congress of the ESCRS
Reference: PO0210 | DOI: 10.82333/35zn-et77
Authors: Ana Maria Ceausescu* 1 , Maria Luisa Merino 1 , Carlos Cuadros Sanchez 1 , Carmen Vivó Devesa 1
1Department of Ophthalmology,Marina Baixa Hospital,Villajoyosa,Spain
The purpose of this study was to observe the wound healing process after traumatic corneal perforation by using anterior segment optical coherence tomography (AS-OCT).
Department of Ophthalmology. Marina Baixa Hospital. Villajoyosa. Alicante. Spain
A 45-year-old man was referred to our emergency department after traumatic ocular injury in his left eye (LE) with a shaving machine. His left best-corrected visual acuity (BCVA) was 0.1. Slit lamp examination revealed corneal edema and full-thickness corneal laceration with positive Seidel test but normal anterior chamber depth. AS-OCT showed complete laceration at the center of the cornea. The iris and anterior lens capsule were not damaged. As the size of perforation was small and the anterior chamber was not shallow, a simple bandage contact lens was placed to seal the wound and medical treatment was initiated. AS-OCT was performed during the follow-up for monitoring of treatment response.
On presentation day, AS-OCT showed a scrambled appearance of the anterior stroma and a heterogeneous stromal reflectivity with an increased corneal thickness. On day 10 after the trauma, the Seidel test was negative, and the use of the soft contact lens was discontinued. Additional topical treatment with corticosteroids was prescribed. Serial AS-OCT evaluation with measurement of corneal thickness was used to follow up the wound healing process. During the reduction of disease level activity, a homogenous hyperreflective stroma and an improvement in the thickness of the corneal stroma were seen. A 4-month follow-up found a hyperdense stromal corneal scar and BCVA of 0.9.
Our results support AS-OCT as a useful tool used to diagnose and manage corneal perforations by providing high-resolution images during the medical therapy to assess its efficacy. The information provided by AS-OCT may be extremely helpful in the assessment of a wide spectrum of anterior segment trauma, guiding in the management and follow-up of these patients.