Yellow dye laser treatment of vascularized corneal stromal scars in pediatric patients.

Patients with a variety of corneal diseases may develop stromal scars that interfere with vision. Vascularization of these scars may lead to inflammation, extravasation of lipid, and progressive opacification. Laser treatment of the neovascular vessels may induce regression of these vessels, with resultant increased corneal clarity and improved vision. We describe the treatment and outcome of 3 pediatric patients with vascularized corneal stromal scars treated with yellow dye laser. Using a PubMed search, we were unable to find any previous reports of this treatment in pediatric patients. Informed consent was obtained from the patients and parents before performing the treatment. The affected eye was pretreated with pilocarpine hydrochloride, 2%. The laser was used with the patients awake using topical proparacaine hydrochloride. An iridotomy contact lens using high ( 25) slitlamp magnification was used. A laser (Lumenis, Santa Clara, California) was used with a wavelength of 568 nm. The spot size was 50 μm. The power ranged from 200 to 300 mW, with a duration of 0.1 second. The laser was begun at the distal (corneal) end of the vessels and continued backward toward the limbus. The power was increased until occlusion of the vessels was visualized. The number of spots per session ranged from 30 to 501. Postoperatively, patients were treated with topical prednisolone acetate, 1%, drops 4 times a day and cyclopentolate hydrochloride, 1%, drops twice a day for 3 days.