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Corneal Keloid: Report of Natural History and Outcome of Surgical Management in Two Cases

Bakhtiari, Pejman MD*; Agarwal, Daniel R. MD; Fernandez, Ana Alzaga MD; Milman, Tatyana MD; Glasgow, Ben MD*; Starr, Christopher E. MD; Aldave, Anthony J. MD*

doi: 10.1097/ICO.0b013e3182a73a10
Case Report

Purpose: To report the natural history and the outcome after the surgical management of 2 cases of corneal keloids.

Methods: Two male patients, 21 and 24 years old, with a history of corneal opacity for 5 and 17 years, respectively, with no history of an ocular trauma were studied.

Results: The first patient initially underwent a superficial keratectomy (SK), after which the corneal opacification recurred. He subsequently underwent 2 SK procedures combined with phototherapeutic keratectomy and mitomycin C, followed by a femtosecond laser–assisted deep anterior lamellar keratoplasty. The second patient underwent a bilateral SK followed by a penetrating keratoplasty in the left eye with the rapid recurrence of the lesion. The patient subsequently underwent an implantation of a Boston type 1 keratoprosthesis in the right eye, with a favorable outcome. The histopathologic features of both excised corneal specimens were consistent with the diagnosis of a corneal keloid.

Conclusions: Corneal keloids recur after SK and phototherapeutic keratectomy, indicating that keratoplasty procedures may be more effective than keratectomy procedures in their management. However, corneal keloids may recur even after a penetrating keratoplasty, in which case keratoprosthesis implantation represents a viable option for visual rehabilitation.

*The Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA;

Department of Ophthalmology, Weil Cornell Medical College, New York City, NY; and

New York Eye and Ear Infirmary, New York, NY.

Reprints: Anthony J. Aldave, The Jules Stein Eye Institute, David Geffen School of Medicine, 100 Stein Plaza, UCLA, Los Angeles, CA 90095-7003 (e-mail: aldave@jsei.ucla.edu).

P. Bakhtiari and D. R. Agarwal contributed equally to this study.

The authors have no funding or conflicts of interest to disclose.

Received June 10, 2013

Accepted July 27, 2013

© 2013 by Lippincott Williams & Wilkins.