Anterior stromal puncture for treatment of contact lens-intolerant keratoconus patients

Su Yeon Kang, Young Kee Park, Jong Suk Song, Hyo Myung Kim

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    Abstract

    Purpose: To report the results and effectiveness of anterior stromal puncture for contact lens-intolerant keratoconus patients with subepithelial fibrotic nodules. Methods: Nine eyes of nine keratoconus patients who were rigid gas-permeable contact lenses (RGP)-intolerant due to subepithelial nodular scars were included in this study. The nine patients were enrolled in the study between March 2008 and December 2008. After confirming nodular elevation from slit-lamp biomicroscopy, the area where the epithelium of nodular scars had sloughed was punctured by anterior stromal puncture using a 26-gauge needle attached to a 1-ml syringe under slit-lamp biomicroscopy. The RGPs of all patients were refitted around 4 weeks after the puncture. Results: Five of the nine patients were male, and the average patient age was 29.6 years (SD∈±∈5.22 years). Mean follow-up time was 13.7 months (SD∈±∈4.8 months), and the epithelial defect healed in 1.4 days on average. After the puncture, four of nine patients presented with a recurrent erosion of the nodule during follow-up and needed a second puncture. All the patients showed good contact lens tolerance and satisfactory contact lens fit. No complications such as corneal perforation or keratitis developed. Conclusions: Anterior stromal puncture using a 26-gauge needle can be a successful and effective method to induce corneal epithelium and Bowman's layer reattachment. It can be used as an outpatient procedure to improve RGP tolerance in patients with keratoconus with elevated subepithelial nodules.

    Original languageEnglish
    Pages (from-to)89-92
    Number of pages4
    JournalGraefe's Archive for Clinical and Experimental Ophthalmology
    Volume249
    Issue number1
    DOIs
    Publication statusPublished - 2011 Jan

    Keywords

    • Anterior stromal puncture
    • Contact lens intolerant
    • Keratoconus
    • Keratoconus nodules

    ASJC Scopus subject areas

    • Ophthalmology
    • Sensory Systems
    • Cellular and Molecular Neuroscience

    Fingerprint

    Dive into the research topics of 'Anterior stromal puncture for treatment of contact lens-intolerant keratoconus patients'. Together they form a unique fingerprint.

    Cite this