What parameters do you use for treating corneal neovascularization with YAG laser and where do you treat - cornea, limbus or conjunctival feeder vessels? I found an article using Abraham lens with 120-480 mw of power, 50-150μm spot size and 0.05 seconds pulse duration (Kumar J, Gehra A, Sirohi N. Role of Frequency Doubled Nd: Yag Laser in Treatment of Corneal Neovascularisation. J Clin Diagn Res. 2016 Apr;10(4):NC01-4. doi: 10.7860/JCDR/2016/17502.7543). Would that be reasonable?
İlk seçenek kornea ve limbus birlikte yapılır veya ikinci seçenek limbus ve konjonktival besleyici damarlar birlikte yapılır. Buradaki amaç birinin güvenliği sağlayıp, diğer ikisini başarıyla kontrol etmek.
Hello!
There is no control group in the study you cited, which is a bit concerning. Corneal neovascularization can decrease over time without any intervention.
First of all, I should note that using specific laser parameters for coagulation without direct visual control can be a bad tactic, since too many factors affect the direct heating of the target tissue. For treatment, you should select those parameters at which you achieve vessel closure without visible damage to the cornea and iris. You should also avoid situations where laser radiation can hit the retina through the pupil or coloboma.
I have some experience performing this procedure. Usually I used a power about 200-400 mW for 200 ms in 200-300 μm spot. Usually in cases of neovascularization after penetrating keratoplasty. I cannot say that the procedure was 100% successful. Don't expect a wow effect.
Thank you for your responses. It is a case of relentless NV and we have tried everything else so I will give it a go.
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