Surgical management and immunohistochemical study of corneal plaques in vernal keratoconjunctivitis.
Two children with shield ulcer in vernal keratoconjunctivitis unresponsive to steroid therapy received plaque removal by superficial keratectomy, followed by amniotic membrane transplantation (AMT). Hematoxylin and eosin staining of the excised corneal specimen revealed a thick layer of eosinophilic material attached to the Bowman's layer. These deposits were positive for eosinophil granule major basic protein, as confirmed by an immunohistochemical study. The shield ulcer healed after the amniotic membrane was removed. No recurrent corneal plaque developed, although corneal opacity complicated in both cases. Lamellar keratectomy with AMT offers an effective management by removing the cytotoxic plaques and protecting the denuded stroma from deposition of inflammatory debris.
Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Hsiu-Yi
HY
Lin
Po-Ting
PT
Yeh
Cheng-Shiang
CS
Shiao
Fung-Rong
FR
Hu
D000293:Adolescent; D000650:Amnion / Q000637:transplantation; D002648:Child; D003233:Conjunctivitis, Allergic / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D003315:Cornea / Q000601:surgery*; D047093:Eosinophil Major Basic Protein / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D008297:Male
D047093:Eosinophil Major Basic Protein
amniotic membrane transplantation; child; eosinophil; shield ulcer; vernal keratoconjunctivitis