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Limbal Stem Cell Deficiency Following Phototherapeutic Keratectomy

Nghiem-Buffet, Minh-Huyên MD; Gatinel, Damien MD; Jacquot, Fabienne MD; Chaine, Gilles MD; Hoang-Xuan, Thanh MD

Case Reports

Purpose. To describe a case of limbal stem cell (LSC) deficiency following phototherapeutic keratectomy (PTK).

Methods. We analyzed the case of a 67-year-old man who developed LSC deficiency in his left eye following PTK for recurrent epithelial erosions. Predisposing factors included diabetes mellitus and rosacea.

Results. Surgical treatment consisted of debridement of the diseased corneal epithelium, followed by limbal autografting from the fellow eye. The cornea healed and remained transparent after 1 year. Histologic examination confirmed the diagnosis of LSC deficiency, showing the presence of goblet cells and inflammatory cells within the epithelium.

Conclusion. The extensive corneal mechanical debridement and laser photoablation incurred during phototherapeutic keratectomy can cause clinical LSC deficiency in patients with predisposing external diseases.

From the Fondation Ophtalmologique A. de Rothschild, 75940 Paris Cedex 19, France; and Service d'Ophtalmologie (M.H.N.B., G.C.), Hôpital Avicenne, 93009 Bobigny Cedex, France.

Submitted December 3, 2002.

Revision received March 27, 2003.

Accepted March 29, 2003.

Address correspondence and reprint requests to Damien Gatinel, Service du Professeur Thanh Hoang-Xuan, Fondation Ophtalmologique A. de Rothschild, 75940 Paris Cedex 19, France. E-mail: gatinel@aol.com

© 2003 Lippincott Williams & Wilkins, Inc.