Fluorescein-potentiated argon laser therapy improves symptoms and appearance of corneal neovascularization.

PURPOSE

To evaluate patients' self-assessment of their symptoms and cosmetic appearance after fluorescein-potentiated argon laser treatment (FPAL) for corneal inflammation associated with neovascularization. To describe the objective effects of FPAL therapy on established corneal neovascularization with secondary corneal edema and lipid keratopathy.

METHODS

Fifteen patients with corneal neovascularization resulting from various infectious and traumatic etiologies were enrolled in an open, nonrandomized pilot study. Treatment consisted of repeated sessions of intravenous fluorescein, a photosensitizer, combined with blue-green argon laser applications to abnormal corneal vessels. Patients completed a written survey to grade their symptoms and cosmetic appearance prior to treatment and at the end of the follow-up period. Objective changes in signs after FPAL treatment were described by two nonmasked ophthalmologists after slit-lamp examinations and review of serial corneal photographs.

RESULTS

Clinical symptoms of blurred vision (p <or= 0.003), photophobia (p <or= 0.03), and cosmetic appearance ( p <or= 0.02) were found to be significantly improved by the patient's subjective assessment survey. There was a trend toward pain reduction (p <or= 0.06) but no apparent reduction in tearing or foreign body sensation (p <or= ns). Objective signs of corneal edema, neovascularization, and lipid keratopathy appeared to be reduced after FPAL therapy.

CONCLUSION

FPAL therapy for corneal neovascularization, edema, and lipid keratopathy resulted in a significant reduction in symptoms and improved quality of life for 14 of 15 (93%) patients. A controlled clinical trial to confirm the reported improvement in signs observed in this pilot study should be considered.