Reduction of hyperopia and astigmatism after superficial keratectomy of peripheral hypertrophic subepithelial corneal degeneration.
OBJECTIVE
To report the development of progressive hyperopia and astigmatism resulting from peripheral hypertrophic subepithelial degeneration which was treated with superficial keratectomy of the lesion.


METHODS
Case report.


RESULTS
A patient with peripheral hypertrophic subepithelial degeneration of both corneas was followed up for a 6-year period. During this time, the patient experienced a slowly progressive increase in hyperopia and astigmatism in both eyes. In the left eye, extension of the degeneration paracentrally resulted in significant hyperopia and astigmatism and a best spectacle-corrected visual acuity of 20/70. Superficial keratectomy was performed and resulted in a dramatic reversal of the hyperopic and astigmatic shift and a best spectacle-corrected visual acuity of 20/30.


CONCLUSIONS
Peripheral hypertrophic subepithelial corneal degeneration can result in progressive flattening of the central corneal topography in the involved meridians. This flattening can induce a significant hyperopic and astigmatic shift in refraction. This refractive change can be reversed with superficial keratectomy to remove the degeneration.
Jeng
Bennie H
BH
Cole Eye Institute, Cleveland Clinic Foundation, OH 44195, USA. jengb@ccf.org
Millstein
Michael E
ME
D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology*; D003317:Corneal Dystrophies, Hereditary / Q000150:complications / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000503:physiopathology*; D054018:Lasers, Excimer; D018903:Photorefractive Keratectomy; D014792:Visual Acuity / Q000502:physiology*