Determination of Surgical Strategies for Burn-Induced Conjunctivalized Corneas Using Optical Coherence Tomography.

PURPOSE: To evaluate the clinical use of optical coherence tomography (OCT) in optimizing surgical treatment strategies for conjunctivalized corneas secondary to ocular burns.

METHODS: This noncomparative observational study included 25 patients with stable ocular burns and conjunctivalized corneas. OCT was performed on each eye. The thickness of corneal opacity or pseudopterygium and the underlying healthy stroma were measured. Individual surgical strategies were performed based on clinical examination and OCT images.

RESULTS: Three types of conjunctivalized corneas were evaluated, including conjunctival pannus (4 of 25), pseudopterygium (10 of 25), and a white fibrovascular membrane (11 of 25). All 25 patients received a procedure of allograft limbal stem cell transplantation. In addition, with information provided in OCT images, 8 patients had combined lamellar keratoplasties; 3 patients had deep anterior lamellar keratoplasties, and 2 patients received penetrating keratoplasties. The remaining 12 patients received limbal stem cell transplantation alone. All fibrovascular tissues were successfully removed from the cornea in all patients.

CONCLUSIONS: OCT is a valuable method in the evaluation of conjunctivalized corneas. This is helpful in determining the surgical treatments for individual patients, allowing for less corneal graft rejection and making good use of corneal donors.