Combined Trans-Epithelial PRK and PTK for Treatment of Corneal Opacity Following Acanthamoeba Keratitis: A Case Report.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL

International Medical Case Reports Journal Pub Date : 2025-05-28 eCollection Date: 2025-01-01 DOI:10.2147/IMCRJ.S495729

Rosa Buonamassa, Giuseppe Addabbo, Francesco Pignatelli, Alfredo Niro, Fedele Passidomo

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Abstract

Purpose: To report a case of Corneal Opacity following Acanthamoeba Keratitis (AK) treated successfully with transepithelial customized Photorefractive Keratectomy (PRK) combined with Photorefractive Keratectomy (PRK).

Methods: One case report.

Results: 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 (CIPTA^®2 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.

Conclusion: Corneal opacity following AK may be successfully treated using a combined topography-guided trans-epithelial PRK and PTK in selected patients.

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联合跨上皮PRK和PTK治疗棘阿米巴角膜炎后角膜混浊1例。

目的：报告1例棘阿米巴角膜炎（AK）术后角膜混浊采用经上皮定制性光屈光性角膜切除术（PRK）联合光屈光性角膜切除术（PRK）成功治疗。方法：报告1例。结果：一名27岁的女性因左眼棘阿米巴角膜炎被转介到我们诊所。感染1年后，患者因出现角膜中央瘢痕和左眼矫正距离视力（CDVA）下降而再次引起我们的注意。裂隙灯检查显示角膜中央混浊，累及前间质。在左眼进行单步地形引导的跨上皮PRK联合PTK （CIPTA®2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以光滑消融表面。随后，在消融表面涂上0.02%丝裂霉素C。在1个月的随访中，观察到角膜混浊的消退，视力改善至20/20，并在3、6和12个月的随访中保持。此外，球面等效性和角膜形态不规则性指数均有改善。结论：在选定的患者中，使用地形引导的跨上皮PRK和PTK联合治疗AK后角膜混浊可能会成功。

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来源期刊

International Medical Case Reports Journal MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

135

审稿时长

16 weeks

期刊介绍： International Medical Case Reports Journal is an international, peer-reviewed, open access, online journal publishing original case reports from all medical specialties. Submissions should not normally exceed 3,000 words or 4 published pages including figures, diagrams and references. As of 1st April 2019, the International Medical Case Reports Journal will no longer consider meta-analyses for publication.