EFFICACY AND SAFETY OF FINE NEEDLE DIATHERMY WITH AND WITHOUT SUBCONJUNCTIVAL TRIAMCINOLONE IN TREATING CORNEAL NEOVASCULARIZATION: A RETROSPECTIVE CASE SERIES STUDY

To assess the efficacy and safety of fine needle diathermy (FND) alone and FND combined with subconjunctival triamcinolone for the treatment of corneal neovascularization (CoNV) across various aetiologies.

Cornea Unit, IInd Academic Ophthalmology Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki

A retrospective case series of patients with CoNV was conducted, including cases of herpes simplex keratitis, bacterial keratitis, acanthamoeba keratitis, pseudomonas keratitis,  marginal keratitis, band keratopathy, corneal ulcers and post-keratoplasty complications. Patients were divided into two groups: those treated with FND and those receiving FND with triamcinolone. Main outcomes included post-treatment visual acuity, extent of treatment across corneal quadrants, number of vessels treated and need for retreatment. Statistical analysis involved paired and independent tests for within- and between-group comparisons and logistic regression analysis to predict the probability of retreatment.

The study included 30 eyes, with 18 in the FND group and 12 in the FND with triamcinolone group. Post-treatment VA was significantly better in the group of FND plus triamcinolone. (p<0.05) A reduction in CoNV, indicated by regression in the number of affected quadrants and treated vessels, was observed in both groups, with the FND plus triamcinolone group showing a more substantial reduction (p<0.05). Retreatment was required in 15% of eyes, more commonly in the FND-alone group. Minimal adverse events were reported. 

Fine-needle diathermy seems to be a safe and efficient treatment option for CoNV and the addition of subconjunctival triamcinolone appears to enhance treatment efficacy in specific cases. Further prospective and larger studies may be warranted to establish optimal treatment protocols.