Topography-guided photorefractive keratectomy with mitomycin C for the treatment of subepithelial corneal infiltrates after epidemic keratoconjunctivitis: case report

Session Details

Session Title: Presented Poster Session: Refractive

Venue: Poster Village: Pod 3

First Author: : M.Ibarz SPAIN

Co Author(s): :    R. Aguejas   P. Fornas   P. Tana                 

Abstract Details

Purpose:

To report visual, refractive and aberrometric changes after topography-guided photorefractive keratectomy with mitomicin C for the treatment of subepithelial corneal infiltrates after epidemic keratoconjunctivitis.

Setting:

Oftalvist Group, Juan Bravo 1, Madrid, Spain.

Methods:

A 28-year old male with history of epidemic keratoconjunctivitis on his right eye two years before, came to our clinic complaining of loss of visual acuity specially for near. Different therapies with topical corticosteroids and cyclosporine, artificial tear drops, contact lenses, and even oral aciclovir had been used with no results. Refraction was: RE +2.00-1.00 x 18º; LE -0.25-0.50 x 174º. Best corrected visual acuity on the right eye was 0.5. Slit lamp examination showed dense subepithelial central fibrosis that was 97 microns depth measured with an anterior segment OCT. Topographic changes were compatible with irregular astigmatism.

Results:

The depth of the scar and the total central pachimetry advised against lamellar keratectomy. Topography-guided photorefractive keratectomy with 2 minutes of intraoperative 0.02% mitomicin c was performed. Refraction programmed was +0.75+0.60 x 10º with an optical zone of 7 mm. For the first two months there was the need to use a soft bandage contact lens due to epithelial irregularity and photophobia that improved gradually. Topical corticosteroids were tapered off over two months. Uncorrected visual acuity at the third month was 1.0 with a refraction +0.50-0.50 x 40º. Topographical, aberrometric and epithelial improvement was confirmed three months after surgery.

Conclusions:

Topography-guided photorefractive keratectomy with intraoperative mitomicin c is an effective option for the treatment of subepithelial fibrosis associated to corneal infiltrates after epidemic keratoconjunctivitis.

Financial Disclosure:

None