title: Reduction of hyperopia and astigmatism after superficial keratectomy of peripheral hypertrophic subepithelial corneal degeneration.
abstract: 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.
authors.affiliation: Cole Eye Institute, Cleveland Clinic Foundation, OH 44195, USA. jengb@ccf.org
authors.forename: Bennie H
authors.initials: BH
authors.lastname: Jeng
authors.forename: Michael E
authors.initials: ME
authors.lastname: Millstein
mesh_terms: 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*