title: Long-term follow-up after lamellar keratoplasty in a patient with bilateral idiopathic corneal keloid.
abstract: OBJECTIVE
  To report a case of bilateral idiopathic corneal keloid.
  
  
  METHODS
  Retrospective review of clinical features, histopathological findings, clinical management, and outcome.
  
  
  RESULTS
  A 2-year-old boy with bilateral corneal keloid was treated with lamellar keratoplasty and tranilast eye drops. Peripheral localized white corneal nodules had been present bilaterally since the age of approximately 6 months in the absence of any history of trauma, inflammatory disease, or relevant family history. Pathological examination of the excised corneal buttons revealed myofibroblast proliferation (positive staining for α-smooth muscle actins), a haphazard arrangement of collagen bundles, and the absence of inflammatory cells. On the basis of these findings, a diagnosis of corneal keloid was assigned. The size of the corneal lesion in the right eye decreased in response to therapy with tranilast eye drops. Lamellar keratoplasty resulted in improved bilateral visual acuity, which was maintained at the 12-year follow-up.
  
  
  CONCLUSIONS
  This report describes a very rare case of bilateral corneal keloid in the absence of trauma or inflammation that was diagnosed by histological and immunohistochemical examination and electron microscopy. Good visual acuity was maintained over an extended period of postsurgery follow-up. Tranilast may represent a novel adjuvant therapy for corneal keloid.
authors: Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. k.fukuda@kochi-u.ac.jp
authors: Ken
authors: K
authors: Fukuda
authors: Tai-ichiro
authors: T
authors: Chikama
authors: Mutsuo
authors: M
authors: Takahashi
authors: Teruo
authors: T
authors: Nishida
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002675:Child, Preschool; D003316:Corneal Diseases / Q000473:pathology / Q000628:therapy*; D016039:Corneal Transplantation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007627:Keloid / Q000473:pathology / Q000628:therapy*; D008297:Male; D016896:Treatment Outcome; D062367:ortho-Aminobenzoates / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D062367:ortho-Aminobenzoates; C012293:tranilast