J Korean Ophthalmol Soc.  2009 Feb;50(2):308-312. 10.3341/jkos.2009.50.2.308.

Late-onset Hypertrophic Corneal Scars After Laser-assisted Subepithelial Keratectomy With Mitomycin C

• Kim DY
• Kim MJ
• Yoon SY
• Shin CJ
• Kim KH
• Tchah H

• KMID: 2212069
• DOI: http://doi.org/10.3341/jkos.2009.50.2.308

Abstract

PURPOSE
To report late-onset hypertrophic corneal scars after laser epithelial keratomileusis (LASEK) with mitomycin C.
CASE SUMMARY
Case 1. A 34-year-old man who had undergone LASEK with mitomycin C 15 months prior was referred to our clinic because of corneal opacity of his right eye. After LASEK, there have been no abnormalities in either of his eyes. However, 11 monthsafter LASEK, he experienced decreased visual acuity in his right eye. The visual acuity was 0.03 in his right eye and 1.0 in his left eye. On slit lamp examination there was a whitish, hypertrophic scarin his right cornea. The lesion was located in the corneal center and the subepithelial space. Central corneal thickness was 828 microm. Case 2. A 23-year-old woman who had undergone LASEK with mitomycin C 14 months before was referred our clinic because of corneal opacity of her left eye. After LASEK, there had been no abnormalities in either of her eyes. However, 12 months after LASEK she experienced decreased visual acuity in her left eye. The visual acuity was 1.0 in her right eye and 0.2 in her left eye. On slit lamp examination there was a whitish, hypertrophic scar in her left cornea. Central corneal thickness was 794 microm.
CONCLUSIONS
Manual debridement was performed to remove the hypertrophic scar in both cases. Case 1. After manual debridement, visual acuity of the right eye improved to 0.63. Case 2. After manual debridement, best-corrected visual acuity of the left eye was 0.63.

Keyword

Corneal opacity; LASEK; Mitomycin

MeSH Terms

Adult
Aminacrine
Cicatrix
Cicatrix, Hypertrophic
Cornea
Corneal Opacity
Debridement
Eye
Female
Humans
Keratectomy, Subepithelial, Laser-Assisted
Mitomycin
Visual Acuity
Young Adult
Aminacrine
Mitomycin

Figure

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  Figure 1. (A) Anterior segment photographs at the first visit. Anterior segment photograph of the right eye shows whitish subepithelial corenal opacity. (B) After manual debridement, there was decreased corneal opacity.

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  Figure 2. (A) Light microscope shows stromal sclerosis. (H & E stain) (B) Smooth muscle actin positive. (Black arrow) (C) Electomicroscope shows 20 nm diameter collagen fibers. (Black arrow)

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  Figure 3. (A) Anterior segment photographs at the first visit. Anterior segment photograph of the her left eye shows dense whitish subepithelial corenal opacity. (B) Ultrasoud biomicroscope shows anterior stromal opacity. (White arrow) (C) After manual debridement, there was decreased corneal opacity which had covered visual axis.

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  Figure 4. (A) Light microscope shows degenerative fibrous tissue sclerosis. (H & E stain) (B) Smooth muscle actin positive. (Black arrow) (C) Electomicroscope shows collagen fibrils and degenerated fibroblast-like cells, consistent with corneal stroma.

Reference

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