Increased corneal scarring after phototherapeutic keratectomy in Fuchs' corneal dystrophy.
OBJECTIVE
A 63-year-old female with Fuchs' endothelial corneal dystrophy, stromal edema and subepithelial scarring was inappropriately treated with phototherapeutic keratectomy, leading to a central focal circular corneal scar and decreased visual acuity that required penetrating keratoplasty.


METHODS
The host corneal button was bisected and fixed in 10% formaldehyde and in glutaraldehyde immediately after its removal.


RESULTS
Light microscopy demonstrated a central area of absent Bowman's layer with a thin layer of subepithelial fibrosis, stromal corneal edema, and thickened Descemet's membrane.


CONCLUSIONS
Correct estimation of differential ablation rates of tissue and shallow, repeated ablations followed by slit-lamp microscopy and/or videokeratography help prevent over-treatment.
Alaa
M
M
El-Maghraby Eye Hospital, Jeddah, Saudi Arabia.
Waring
G O
GO
Malaty
A
A
Grossniklaus
H
H
D002921:Cicatrix / Q000209:etiology* / Q000601:surgery; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D015715:Corneal Edema / Q000150:complications / Q000473:pathology; D003886:Descemet Membrane / Q000473:pathology; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000473:pathology; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015948:Keratoplasty, Penetrating; D054018:Lasers, Excimer; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000601:surgery; D012086:Reoperation