Pressure-Induced Stromal Keratopathy after Surface Ablation Surgery.

IF 0.5 Q4 OPHTHALMOLOGY

Case Reports in Ophthalmology Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI:10.1159/000539701

Jaime Guedes, Rodrigo Vilares-Morgado, Rodrigo Brazuna, Alexandre Costa Neto, Denisse Josefina Mora-Paez, Marcella Q Salomão, Fernando Faria-Correia, Renato Ambrósio

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引用次数: 0

Abstract

Introduction: The purpose of this clinical report was to describe an unprecedented case of bilateral pressure-induced stromal keratopathy (PISK) following corneal photorefractive keratectomy, associated with presumed herpetic keratitis, and to present tomographic and biomechanical findings before and after appropriate treatment.

Case presentation: A 33-year-old male patient was referred to our clinic with suspected delayed corneal epithelial healing 3 weeks after an uncomplicated PRK. A central layer of corneal opacity with a presumed fluid-filled interface area was observed upon slit lamp biomicroscopy. Scheimpflug images from the Pentacam^® revealed a hyperreflective area beneath the central cornea. Scheimpflug-based corneal tomography, biomechanical assessment using the Pentacam^® AXL Wave, and the Corvis ST^® were conducted. Goldmann applanation tonometry measured 23/13 mm Hg, while noncontact tonometry intraocular pressure measured with the Corvis ST^® (Corvis ST IOPnct) was 40.5/43.5 mm Hg. Treatment with oral valacyclovir, combined with ocular hypotensive therapy, led to a significant reduction in IOP and improved corneal deformation parameters after 1 month.

Conclusion: Surgeons should be aware of the inaccuracy of Goldmann applanation tonometry in PISK, which can occur after LASIK or surface ablation.

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表面消融手术后压力引起的基质角膜病变

导言：本临床报告旨在描述一例史无前例的角膜光屈光性角膜切除术后双侧压力诱导基质角膜病（PISK）病例，该病例伴有假定的疱疹性角膜炎，并介绍适当治疗前后的断层扫描和生物力学结果：一名 33 岁的男性患者在接受了不复杂的角膜屈光手术（PRK）3 周后，因怀疑角膜上皮愈合延迟而被转诊至我院。在裂隙灯生物显微镜下观察到角膜中央有一层混浊，推测是充满液体的界面区。来自 Pentacam® 的 Scheimpflug 图像显示角膜中央下方有一个高反射区。该患者接受了基于 Scheimpflug 的角膜断层扫描、使用 Pentacam® AXL Wave 和 Corvis ST® 进行的生物力学评估。戈德曼眼压计测得的眼压为 23/13 毫米汞柱，而用 Corvis ST® 测得的非接触眼压计眼压（Corvis ST IOPnct）为 40.5/43.5 毫米汞柱。口服伐昔洛韦并结合降眼压疗法治疗一个月后，眼压显著下降，角膜变形参数也得到改善：外科医生应注意戈德曼眼压计在 PISK 中的不准确性，这可能发生在 LASIK 或表面消融术之后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Ophthalmology OPHTHALMOLOGY-

CiteScore

0.90

自引率

0.00%

发文量

129

审稿时长

12 weeks

期刊介绍： This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.