Buonamassa Rosa, Addabbo Giuseppe, Pignatelli Francesco, Niro Alfredo, Passidomo Fedele
Eye Clinic, P.O. "Madonna delle Grazie", Matera, Italy.
Eye Clinic, "SS. Annunziata" Hospital, ASL Taranto, Taranto, Italy.
Int Med Case Rep J. 2025 May 28;18:629-635. doi: 10.2147/IMCRJ.S495729. eCollection 2025.
To report a case of Corneal Opacity following Acanthamoeba Keratitis (AK) treated successfully with transepithelial customized Photorefractive Keratectomy (PRK) combined with Photorefractive Keratectomy (PRK).
One case report.
A 27-year-old woman was referred to our clinic for Acanthamoeba keratitis in her left eye. After 1 year from the infection, the patient returned to our attention for developing a central corneal scar and decreased corrected distance visual acuity (CDVA) in the left eye. The slit-lamp examination showed a central corneal opacity involving anterior stroma. A single-step topography-guided trans-epithelial PRK combined with PTK (CIPTA2 software, iVis Technologies) was performed in the left eye. After surface ablation using PRK, PTK was performed using masking agents (1% hydroxymethylcellulose) to smooth the ablated surface. Subsequently, 0.02% Mitomycin C was applied over the ablated surface. At the 1-month follow-up, a resolution of the corneal opacities was observed, with a visual improvement to 20/20, which was maintained at the 3-, 6-, and 12-months follow-up. Furthermore, there was an improvement in spherical equivalent and corneal morphological irregularity index.
Corneal opacity following AK may be successfully treated using a combined topography-guided trans-epithelial PRK and PTK in selected patients.
报告1例棘阿米巴角膜炎（AK）后角膜混浊患者，采用经上皮定制准分子原位角膜磨镶术（PRK）联合准分子原位角膜磨镶术成功治疗。
病例报告。
一名27岁女性因左眼棘阿米巴角膜炎转诊至我院。感染1年后，患者因左眼出现中央角膜瘢痕和矫正远视力（CDVA）下降再次前来就诊。裂隙灯检查显示中央角膜混浊累及前基质层。左眼行单步地形图引导的经上皮PRK联合光化学角膜切削术（PTK）（CIPTA2软件，iVis Technologies）。使用PRK进行表面消融后，使用掩蔽剂（1%羟甲基纤维素）进行PTK以平滑消融表面。随后，在消融表面应用0.02%丝裂霉素C。在1个月的随访中，观察到角膜混浊消退，视力提高到20/20，在3个月、6个月和12个月的随访中保持稳定。此外，等效球镜和角膜形态不规则指数也有所改善。
对于部分患者，采用联合地形图引导的经上皮PRK和PTK可成功治疗AK后的角膜混浊。
