Mejía L F, Acosta C, Santamaría J P
Instituto de Ciencias de la Salud-CES, Medellín, Colombia.
Cornea. 2001 May;20(4):421-4. doi: 10.1097/00003226-200105000-00017.
To describe the cause, diagnosis, and management of a case of bilateral corneal keloid.
We describe a 17-year-old white boy with enlarging nontraumatic bilateral corneal scars whose growth was exacerbated by a superficial keratectomy. The patient underwent a penetrating keratoplasty (PK) in his left eye. Light and electron microscopy of the corneal button were performed.
The histopathologic and ultrastructural features of the corneal button were haphazardly arranged collagen fascicles with activated fibroblasts but no inflammatory cells. The clinical outcome was excellent, although there has been continuous growth of the outer margin of the initial lesion not included in the PK. This growth has not affected vision. The unoperated right corneal lesion progressively enlarged during these years.
A corneal keloid, although unusual, should be suspected in cases of enlarging white glistening avascular corneal scars regardless of a traumatic antecedent. Light and electron microscopy confirmed the diagnosis. Management is by PK when the visual axis is involved and carries an excellent prognosis.
描述一例双侧角膜瘢痕疙瘩的病因、诊断及处理方法。
我们描述了一名17岁的白人男孩，患有双侧非创伤性角膜瘢痕且瘢痕不断增大，表面角膜切除术使其生长加剧。该患者左眼接受了穿透性角膜移植术（PK）。对角膜植片进行了光镜和电镜检查。
角膜植片的组织病理学和超微结构特征为胶原束排列紊乱，有成纤维细胞活化，但无炎症细胞。临床结果良好，尽管最初病变未包含在PK范围内的外缘一直在持续生长。这种生长未影响视力。这些年未手术的右眼角膜病变逐渐增大。
尽管角膜瘢痕疙瘩不常见，但对于白色、有光泽、无血管的角膜瘢痕增大的病例，无论有无外伤史，均应怀疑该病。光镜和电镜检查确诊了该病。当视轴受累时，通过PK进行处理，预后良好。
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