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Review
. 2023 Jan 1;49(1):42-44.
doi: 10.1097/ICL.0000000000000959. Epub 2022 Nov 16.

Treatment for Intracorneal Hematoma by Anterior Chamber Gas Tamponade Combined With Keratocentesis

Hiroshi Toshida  1 , Yusuke Hayashi, Kohei Ichikawa
Affiliations
Review

Treatment for Intracorneal Hematoma by Anterior Chamber Gas Tamponade Combined With Keratocentesis

Hiroshi Toshida et al. Eye Contact Lens. .

Abstract

Purpose: To report a new surgical method for intracorneal hematoma removal using combination of keratocentesis and gas tamponade in the anterior chamber.

Methods: We reviewed the clinical course and outcomes of surgical intervention.

Results: An 82-year-old woman visited our department because of a sudden decline in visual acuity (20/800 on the Snellen chart) in her left eye. We observed neovascularization from the superior corneal limbus and a hematoma near the Descemet membrane, deep in the stroma of the corneal center. Filtered air was injected into the anterior chamber, keratocentesis was performed at four locations from the corneal epithelium through the stroma, and the hematoma was removed from the puncture sites. The corneal hematoma disappeared, and the best-corrected visual acuity reached 20/20 at postoperative month 4.

Discussion: Combination of keratocentesis and gas tamponade in the anterior chamber is a simple and effective method for removing intracorneal hematomas.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

Figures

FIG. 1.
FIG. 1.
Ocular finding of the intracorneal hematoma under the Descemet membrane. (A) Intracorneal hematoma covering the pupillary area on the first visit to our hospital. (B) Ocular image of the same eye taken from the temporal side. (C) At 4 months after the surgery, the pupillary area became transparent, although few corneal stroma opacites remained between the layers. (D) Anterior segment OCT showing intracorneal hematoma under the Descemet membrane at the first visit. (E) Image of the anterior segment OCT 4 months after the surgery. No intracorneal hematoma was observed 4 months after the treatment. OCT, optical coherence tomography.
FIG. 2.
FIG. 2.
Surgical methods for anterior chamber gas tamponade combined with keratocentesis. (A) Cauterization of vessels in the superior corneal limbus. (B) Injection of filtered gas into the anterior chamber with a 32-G needle. (C) Keratocentesis with a 24-G V lance needle from the corneal epithelium to the stroma. (D) Scraping the cornea with a spatula to remove the hematoma between the layers by means of puncture.
See this image and copyright information in PMC

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