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Intracorneal silicone injection may offer pain relief in eyes with bullous keratopathy
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WARSAW, Poland — Intracorneal injection of a transparent, biocompatible hydrophobic material is a fast, minimally invasive and promising new technique for the treatment of bullous keratopathy, according to a specialist.
The ideas was first developed by George D. Kymionis, MD, PhD, who observed during vitreoretinal surgery that silicone oil that penetrates into the anterior chamber works as a hydrophobic barrier, Ioannis G. Pallikaris, MD, PhD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Ioannis G. Pallikaris
The technique entails using the lamellar keratoplasty treatment software of the WaveLight FS200 femtosecond laser (Alcon) to create a stromal pocket through a specially designed keyhole-shaped mask inserted in the applanation cone. The silicone material is then injected into the pocket, where it creates a protective bubble that prevents the fluid from moving into the stroma and epithelium.
Pallikaris presented the results from a case series in which the technique was employed in four eyes legally blind due to open-angle glaucoma that developed bullous keratopathy after cataract surgery. All patients had severe pain symptoms.
The treatment resulted in complete re-epithelialization and relief of symptoms.
“Relief was almost immediate. About 1 hour following injection, patients were free of pain,” Pallikaris said.
The silicone material was visible by optical coherence tomography as a tiny film in the middle of the stroma, still in place 1 year later.
“The overall outcome is excellent. At 1 year, patients are still happy and the epithelium is in good condition,” Pallikaris said.
Disclosure: Pallikaris has no relevant financial disclosures