Korean J Ophthalmol.  2014 Feb;28(1):86-90. 10.3341/kjo.2014.28.1.86.

Treatment of an 8-mm Myxoma Using Acellular Corneal Tissue

• Lim KS
• Wee SW
• Kim JC

• KMID: 1792098
• DOI: http://doi.org/10.3341/kjo.2014.28.1.86

Abstract

A myxoma is a benign tumor found in the heart and in various soft tissues; however, a corneal myxoma is rare. A mucinous mass of unknown etiology was observed on the left cornea of a 32-year-old male patient. We performed deep anterior lamellar keratoplasty using acellular corneal tissue and concurrent amniotic membrane transplantation. Hematoxylin and eosin staining revealed vacuolation of the parenchyma and myxoid change in the corneal tissue that occurred in the anterior half of the corneal parenchyma. We identified a myxoid stroma by Alcian blue staining and observed collagen fibers with denatured stroma by Masson trichrome staining. The patient's visual acuity improved from light perception to 20 / 200, and the intraocular pressure remained within the normal range for one year after surgery. The transplanted cornea survived successfully with well-maintained transparency, and recurrence was not observed one year after surgery.

Keyword

Corneal stroma; Corneal transplantation; Myxoma

MeSH Terms

Adult
*Cornea
Corneal Stroma/cytology/*transplantation
Corneal Transplantation/*methods
Eye Neoplasms/diagnosis/*surgery
Humans
Male
Myxoma/diagnosis/*surgery

Figure

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  Fig. 1 (A) A preoperative anterior segment photograph of the left eye shows a jelly-like corneal degeneration (8.7 × 7 mm). (B,C) Anterior optical tomography (Visante OCT) shows a 1.39-mm full-thickness cornea and a 0.89-mm-deep area of corneal degeneration.

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  Fig. 2 (A) A postoperative anterior segment photograph taken 90 days after deep anterior lamellar keratoplasty of the left eye showing a completely healed cornea. (B) Almost corneal epithelial defects had healed by three months after surgery.

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  Fig. 3 The lesion is covered by degenerated squamous epithelium. The underlying stroma shows marked myxoid and vacuolar degeneration, with positive Alcian blue staining. A few fibroblast-like spindle cells are scattered in the degenerated stroma. (A) Hematoxylin and eosin, ×40; (B) Alcian blue stain, ×40.

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  Fig. 4 A high-magnification view of the stroma shows uninucleated (arrowhead) and multinucleated (arrow) spindle cells scattered throughout the myxoid stroma (Alcian blue stain, ×200).

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  Fig. 5 Marked vacuolar changes in the myxoid corneal stroma (Alcian blue stain, ×200).

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  Fig. 6 (A) The periphery of the lesion showing a loose, hypocellular, minimal collagen-depositional, glycosaminoglycan-rich lesion in the subepithelial anterior stroma (M), in sharp contrast to the normal deep stroma (N). (B) The central site of the lesion showing vacuolar changes in the deep stroma (V). Masson trichrome stain, ×100.

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