Optical coherence tomography of corneal and scleral melts

Corneal and scleral melts can be difficult to assess by slit-lamp due to the overlying opacity. The authors demonstrate the role of optical coherence tomography (OCT) in the diagnosis and management of two cases of corneal and scleral melt. A high-speed anterior segment OCT system operating at a 1,310-nm wavelength was used. Cross-sectional OCT images showed the depth and extent of the melt. OCT images were obtained through an opaque pannus in one case and through a calcium plaque in the other. OCT images at the follow-up examination revealed a thin fluid space between the amniotic graft and cornea and its subsequent resolution in the first case and the fits of an epicardial graft and a subsequent clear lamellar corneal graft in the second case. OCT images allow physicians to assess melts through opaque media and subsequent graft integration after repair.