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Management of the Vascularized Cornea Before Corneal Graft Surgery: Fine-Needle Diathermy and Inhibition of VEGF

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Modern Keratoplasty

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

Corneal neovascularization (CNV) is a pathological process that happens as a response to different stimuli, which impairs in many ways the transparency, refractive and immunologic health of the cornea. Notably, it appears as an accelerator and instigator of graft rejection prior to corneal transplantation, namely on penetrating keratoplasties (PK) and the ophthalmologist should identify it and treat it prior to surgery to prolong graft survival. In this chapter, we review the epidemiology, risk factors and pathophysiology of corneal neovascularization, as well as its impact on subsequent PK survival among other types of corneal transplantation. We specifically elucidate different medical and surgical therapies for managing corneal neovascularization prior to PK with the use of fine-needle diathermy, laser therapy and anti-VEGF agents. Novel procedures incorporating anti-VEGF use such as scleral lens devices are also described.

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Suggested Reading

  1. Perez VL. Corneal vessel cauterization. Durham: Duke Eye Center; 2022.

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Authors and Affiliations

  1. Foster Center for Ocular Immunology, Duke Eye Institute, Durham, NC, USA

    Nadim S. Azar, Matias Soifer & Victor L. Perez

  2. Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA

    Nadim S. Azar, Matias Soifer & Victor L. Perez

  3. Foster Center for Ocular Immunology at Duke Eye Center, Duke University School of Medicine, Durham, NC, USA

    Victor L. Perez

Authors
  1. Nadim S. Azar
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  2. Matias Soifer
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  3. Victor L. Perez
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Correspondence to Victor L. Perez .

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Editors and Affiliations

  1. Vissum Miranza, Miguel Hernández University, Alicante, Spain

    Jorge L. Alió

  2. Vissum-Instituto Oftalmologico de Alica, Miguel Hernandez University, Alicante, Alicante, Spain

    Jorge L. Alió del Barrio

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Cauterization of corneal stromal vessels during corneal transplantation surgery (MP4 14433 kb)

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Azar, N.S., Soifer, M., Perez, V.L. (2023). Management of the Vascularized Cornea Before Corneal Graft Surgery: Fine-Needle Diathermy and Inhibition of VEGF. In: Alió, J.L., del Barrio, J.L.A. (eds) Modern Keratoplasty. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-031-32408-6_4

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  • DOI: https://doi.org/10.1007/978-3-031-32408-6_4

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