Ghanem Ramon Coral, Piccinini André Luís, Ghanem Vinícius Coral
J Refract Surg. 2017 Jan 1;33(1):53-55. doi: 10.3928/1081597X-20161027-03.
To describe a case of Meesmann's epithelial corneal dystrophy that underwent photorefractive keratectomy (PRK) with mitomycin C.
Case report.
A 36-year-old woman was evaluated for refractive surgery. She had a history of recurrent epithelial erosions and moderate visual loss over the past 10 years. Biomicroscopy revealed bilateral micro-cystic epithelial lesions and a diagnosis of Meesmann's epithelial corneal dystrophy was proposed. Corneal optical coherence tomography showed epithelial thickening with apparent intraepithelial cysts in the superficial layers. The patient's daughter's examination showed the same biomicroscopy pattern. PRK was performed. Epithelial healing was uneventful and only tiny microcysts could be observed after 3 months. However, complete recurrence of the intraepithelial cysts were observed after 1 year with visual acuity dropping due to residual refractive error.
This case suggests that residual refractive error and recurrence of the cystic lesions and punctate erosions should be anticipated after PRK in patients with Meesmann's epithelial corneal dystrophy. [J Refract Surg. 2017;33(1):53-55.].
描述1例接受丝裂霉素C准分子激光角膜切削术(PRK)治疗的米斯曼上皮性角膜营养不良病例。
病例报告。
一名36岁女性接受屈光手术评估。她在过去10年中有复发性上皮糜烂和中度视力下降病史。生物显微镜检查发现双侧微囊性上皮病变,拟诊断为米斯曼上皮性角膜营养不良。角膜光学相干断层扫描显示上皮增厚,表层有明显的上皮内囊肿。对患者女儿的检查显示了相同的生物显微镜检查模式。实施了PRK。上皮愈合顺利,3个月后仅观察到微小的微囊肿。然而,1年后观察到上皮内囊肿完全复发,因残余屈光不正导致视力下降。
该病例表明,米斯曼上皮性角膜营养不良患者接受PRK后,应预期会出现残余屈光不正以及囊性病变和点状糜烂的复发。[《屈光手术杂志》。2017;33(1):53 - 55。]