[Neurotrophic keratopathy--a post-LASIK case report].
BACKGROUND
Neurotrophic keratopathy is a degenerative affection of the cornea caused by impairment of corneal sensitivity and represents a therapeutic challenge for ophthalmologists. The present article concentrates on the etiology, pathogenesis, diagnosis, therapeutic aspects and future therapeutic models for treating neurotrophic keratopathy and will present a case report: Also we evaluate the effects of autologous serum eye drops in bilateral LASIK-induced neurotrophic keratopathy with epithelial breakdown revealed by positive fluorescence and rose bengal staining and reduced tear film break-up time.


METHODS
We treated a 42-year-old patient with post-LASIK neurotrophic keratopathy and tear film instability with autologous serum eye drops (5 x daily) and emulsion eye drops (Refresh Endura, Allergan, Irvine, CA, USA) after insertion of punctal plugs.


RESULTS
Stabilization of vision, healing of the epithelium and reduction of the previously experienced symptoms like redness, itching and burning were achieved within 6 weeks. 10 months after changing therapy, the patient only complained about slight pain during lid movement.


CONCLUSIONS
Severe denervation after bilateral LASIK disrupts ocular tear film dynamics and causes irritation symptoms of the ocular surface. Autologous serum eye drops may be an effective treatment of severe epithelial breakdown and be helpful to reestablish the disturbed ocular surface integrity, as shown by negative vital staining. Therefore, autologous serum eye drops represent a significant approach in the therapy of LASIK-induced severe dry eye and associated pain.
Fuchsluger
T A
TA
Zentrum für Augenheilkunde, Abt. für Erkrankungen des vorderen Augenabschnitts, Universitätsklinikum Essen. thomas@fuchsluger.net
Steuhl
K-P
KP
Meller
D
D
D000328:Adult; D001798:Blood Proteins / Q000627:therapeutic use*; D003320:Corneal Ulcer / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007634:Keratitis / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D044967:Serum / Q000737:chemistry; D016896:Treatment Outcome
D001798:Blood Proteins; D009883:Ophthalmic Solutions