La prise en charge des néovaisseaux cornéens avant greffe de cornée : à propos de 112 cas

Abstract

The avascular nature of the cornea results from a balance between angiogenic factors and anti-angiogenic factors. Under pathological conditions, this homeostasis can be disturbed, resulting in the onset of corneal neovascularization. The purpose of our study was to report our experience in the management of corneal neovascularization prior to keratoplasty. This is a prospective study of 112patients with corneal neovascularization and candidates for possible corneal transplant. The average age of patients was 38years, ranging from 15to 72years. The etiologies of neovascularization were dominated by ocular trauma (26.8%). In total, 48.33% of patients had superficial neovascularization, 18.52% moderately deep and 33.2% deep neovascularization. All patients received topical corticosteroids, 29.4% received subconjunctival injections of bevacizumab, and 22.32% intrastromal bevacizumab injections. Clinical course was marked by a decrease in the percentage of corneal neovascularization compared to the total corneal surface area, from 45% (between 16and 82%) to 28% (between 0and 69%) at Day 120. There was no statistically significant improvement in visual acuity. Corneal neovascularization is a major risk factor for graft rejection; its management is crucial prior to every keratoplasty. Corneal neovascularization can lead to increased risk of graft rejection. Proper management increases the success rate of penetrating keratoplasty.