Intracorneal Hemorrhage Research Articles

Femtosecond laser-assisted corneoscleral lamellar keratoplasty for peripheral corneal disease

Objective: To evaluate the effect of femtosecond laser-assisted corneoscleral lamellar keratoplasty (FL-CSLK) on peripheral corneal disease (PCD). Methods: Retrospective cohort study. Six patients (6 eyes) with PCD who underwent FL-CSLK in Qingdao Eye Hospital from March 2014 to March 2017 were grouped as the FL-CSLK group, including 4 males and 2 females, aged (46.7±17.9) years. In addition, 8 patients (8 eyes) with PCD who underwent traditional corneoscleral lamellar keratoplasty in the same period were included in the control group. The items for analyses were as follows: visual function recovery, including visual acuity, equivalent spherical power, and astigmatism; the state of the cornea, including the healing time of the corneal epithelium, the transparency of the graft, the thickness of the corneal graft and implant bed, and the loss rate of corneal endothelial cells; intraoperative and postoperative complications, including high intraocular pressure, interlayer effusion, delayed corneal epithelial healing, immune rejection, and primary recurrence. Paired t-test was used to compare the best corrected visual acuity (BCVA), equivalent spherical power, and astigmatism before and after operation. The BCVA and corneal graft epithelial healing time between the two groups were compared by independent sample t-test. Results: The 6 patients in the FL-CSLK group included 2 cases of Mooren ulcer, 3 cases of Terrien marginal degeneration, and 1 case of pellucid marginal degeneration. The control group consisted of 4 eyes with Mooren ulcer and 4 eyes with Terrien marginal degeneration. The BCVA (logarithm of the minimum angle of resolution) in the FL-CSLK group was 0.35±0.09 at 6 months after operation, which was significantly higher than that before operation (1.17±0.15; t=9.01, P<0.001) and at 6 months after operation in the control group (0.78±0.29; t=-3.96, P=0.003). The equivalent spherical power was (4.8±2.7) D, lower than that before operation (t=-3.71, P=0.014), and the astigmatism power was (10.1±4.1) D, lower than that before operation (t=6.04, P=0.002) in the FL-CSLK group. The healing time of the graft epithelium in the FL-CSLK group and control group was (8.5±3.3) days and (12.8±6.1) days, respectively, with no significant difference (t=-1.54, P=0.149). The central thickness of the graft in the FL-CSLK group was (525±47) μm at 6 months after operation, the central thickness of the implant bed was (189±119) μm, and the loss rate of the corneal endothelium was 7.5%±2.1%. In the control group, 1 case had intraoperative perforation, 2 cases had intracorneal hemorrhage, and 1 case had intracorneal epithelial implantation cysts and graft ulcer. There were no intraoperative and postoperative complications in the FL-CSLK group. Conclusions: FL-CSLK can yield good clinical results in the treatment of PCD. The smooth optical interface made by femtosecond lasers can help the patient achieve a good visual prognosis. The procedure reduces the risk of corneal perforation and thus improves the surgery safety.

Intracorneal stromal hemorrhage in dogs and its associations with ocular and systemic disease: 39 cases.

To describe clinical features of dogs diagnosed with stromal intracorneal hemorrhage (ICH). Retrospective case series of 39 dogs (44 eyes) with ICH. Medical records of dogs evaluated by the Cornell University ophthalmology service were searched to identify animals with a clinical diagnosis of ICH between 2005 and 2014. Signalment and clinical details, including concurrent ocular disease, concurrent systemic disease, diagnostic tests performed, outcome of hemorrhage, presenting client complaint, and treatment, were recorded. Intracorneal hemorrhage was identified in 44 eyes of 39 dogs. The mean (±standard deviation) age of dogs was 11.5 years (±2.8 years). The Bichon Frise breed and older dogs were statistically over-represented relative to the entire ophthalmology service canine referral population during the same time period. Concurrent ocular disease was present in 40 eyes (91%) and included keratoconjunctivitis sicca, cataracts, and corneal ulcers. Twenty-three dogs (59%) suffered from concurrent systemic disease, most frequently diabetes mellitus, hyperadrenocorticism, hypothyroidism, and systemic hypertension. Less commonly, life-threatening systemic conditions were identified in dogs with ICH including immune-mediated hemolytic anemia, immune-mediated thrombocytopenia, metastatic neoplasia, and sepsis. Intracorneal hemorrhage was found in all corneal locations, and corneal vascularization was present in each affected eye. Intracorneal hemorrhage is an uncommon condition in dogs that occurs in association with corneal vascularization. The risk of ICH may be increased due to certain ocular and systemic diseases. Although uncommon, ICH may also be an ocular manifestation of severe immune-mediated, infectious, and neoplastic systemic diseases in dogs.

Descemet Membrane Detachment After Canaloplasty

To report the incidence and management of Descemet membrane detachment (DMD) after canaloplasty. Review of all patients who developed DMD after canaloplasty at Tulane Glaucoma Services was performed. Visual acuity, intraocular pressure, and number of glaucoma medications up to 1 year of follow-up were included in the analysis. The incidence of DMD was 7.4% (12 eyes of 162). Eighty-three percent (10/12) of the DMDs involved the inferior quadrants and measured <3 mm. Intracorneal hemorrhage within DMD occurred in 58% (7/12), whereas 42% (5/12) developed DMD with intracorneal viscoelastic (Healon GV) alone. Two patients had large detachments measuring 5 to 6 mm extending into the visual axis. DMD resolved completely with or without drainage except for 1 patient who developed corneal decompensation, needing penetrating keratoplasty. DMD with or without intracorneal hemorrhage is not an infrequent complication of canaloplasty and can occasionally lead to corneal decompensation.

Intracorneal hemorrhage in 19 dogs (22 eyes) from 2000 to 2010: a retrospective study

The aim of this retrospective study is to review clinical data on patients that suffered intracorneal hemorrhage (ICH), and the veterinary and human literature available for this condition. A search for ICH was performed within the clinical database of the Animal Health Trust. Nineteen cases were identified (22 eyes). The patient's age, breed, and gender were reviewed, together with etiology, location, treatment, and follow-up. The relevant data were compared with the Animal Health Trust (AHT) ophthalmology referral population for the same period of time (n=5555). Twenty-two eyes were affected. No breed or sex predisposition could be identified. Patients aged 10 years and above were more frequently affected when compared with the AHT ophthalmology referral population. ICH was recorded in all corneal quadrants, with the mid-peripheral cornea more often affected. Areas of corneas affected by the ICH showed long-term loss of transparency. Ocular diseases as a source of neovascularization varied from ocular surface to intraocular disease. Systemic diseases were investigated in some patients, and no concomitant disease could be linked to the development of ICH. Intracorneal hemorrhage is a rare condition associated with corneal neovasculature. As in the human ophthalmology literature, ICH could not be linked to a specific ocular or systemic disease. Severe complications described in humans with this condition, such as pupillary block or corneal perforation, were not seen in any of these canine patients. Canine ICH seem to reabsorb with time, with or without medical treatment. Surgical treatment was not required in any of our patients.

Subconjunctival and Intracorneal Bevacizumab Injection for Corneal Neovascularization in Lipid Keratopathy

The purpose of this study was to evaluate the efficacy and safety of subconjunctival and corneal intrastromal bevacizumab injections on corneal neovascularization in patients with lipid keratopathy. Three eyes of 3 patients with lipid keratopathy accompanied by corneal neovascularization received at least 2 subconjunctival and corneal intrastromal injections of bevacizumab (1.25 mg/0.05 mL, respectively) at 1-month intervals. Ophthalmic examinations, including visual acuity, tonometry, slit lamp biomicroscopy, and corneal topography, were performed before injection and every month thereafter. All patients had marked regression of corneal neovascularization. Reduction in lipid deposition was noted in one patient. There were no adverse ocular or systemic events, except for a small intracorneal hemorrhage noted in one patient, which quickly and spontaneously cleared. Subconjunctival and intracorneal bevacizumab is a well-tolerated and effective method for obliterating corneal neovascularization in lipid keratopathy.

Layered pre-descement intracorneal hemorrhage in a patient with end-stage glaucoma

A patient receiving anticoagulant therapy, who had a history of neovascular glaucoma secondary to proliferative diabetic retinopathy, presented with sudden loss of vision. He was found to have a layered, posterior, intracorneal hemorrhage associated with a Descement membrane detachment. Deep intracorneal hemorrhage may result in patients who have neovascular glaucoma with probable deep corneal neovascularization, possibly aggravated by anticoagulant therapy.

Intracorneal hematoma in Mooren ulceration

PURPOSE: To report a case of intracorneal hematoma occurring in association with Mooren ulceration. METHOD: Case report. RESULTS: In an 81-year-old man with bilateral Mooren ulceration, a dense intracorneal hemorrhage occurred in the right eye secondary to peripheral corneal neovascularization and was followed by slow resolution over a 3-year period. Following subsequent lamellar and penetrating keratoplasty, histopathologic examination demonstrated the association between the stromal neovascularization and the residual interlamellar hemorrhage, as well as phagocytosis of residual hemosiderin by macrophages. CONCLUSION: Intracorneal hematoma with spontaneous resolution has been documented clinically and histopathologically in an eye with Mooren ulceration.

Keratohematoma Leading to Acquired Posterior Keratoconus

We describe a patient with congenital syphilis associated with corneal neovascularization and subsequent intracorneal hemorrhage. Over time, this condition resulted in acquired posterior keratoconus. A review of our clinical case, the literature, and histologic findings is presented. To our knowledge, this is the first reported case of acquired posterior keratoconus associated with corneal vascularization and hemorrhage secondary to congenital syphilis. We also have provided histopathologic evidence for the prescence of an iron ring.

Biomicroscopic and Histopathologic Observations After Corneal Laser Photocoagulation in a Rabbit Model of Corneal Neovascularization

Corneal neovascularization complicates many anterior segment diseases. Corneal laser photocoagulation using yellow light (577 nm) has been shown to reduce corneal neovascularization. No histopathologic studies of the effects of this treatment on the eye have been reported, however. Target (cornea) and nontarget (iris, lens, retina, and choroid) ocular tissue were studied 1, 24, and 48 h and 5 days after yellow dye corneal laser photocoagulation in a rabbit model of corneal neovascularization. Biomicroscopic examination of the corneas revealed intracorneal hemorrhage in five of 24 (21%) eyes of nonpigmented rabbits. Faint lenticular opacities were observed in two eyes of pigmented rabbits 24 h after laser treatment. Histopathologic examination revealed increased cellularity (neutrophils) (p < 0.005) in the cornea, increasing from 1 h after treatment, peaking 24 h later, and persisting past 5 days. Distortion of the corneal lamellae by red blood cells occurred in eyes in which intracorneal hemorrhage developed. These results indicate that corneal laser photocoagulation using yellow light is a relatively safe procedure for reducing corneal neovascularization.

Contact Lens-related Deep Stromal intracorneal Hemorrhage

Deep corneal neovascularization is a recently described complication of contact lens wear. Visual loss associated with deep corneal neovascularization has been associated with stromal lipid leakage. Deep intracorneal hemorrhage is rare and has been documented infrequently with the use of contact lenses. The authors present five cases of deep stromal hemorrhage associated with contact lens-related deep corneal neovascularization. These patients had no other discernible cause for their vascularization and subsequent hemorrhage. One patient required a penetrating keratoplasty for visual rehabilitation. Contact lenses of all types may cause neovascularization. The deep stromal neovascularization develops insidiously and may progress in the absence of acute symptoms. The presence of deep stromal neovascularization must be watched carefully and managed as a potentially vision-threatening complication of contact lens use.