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Traumatic epithelial downgrowth after radial keratotomy
Ajit Nemi1, Rosanna P Bahadur, J Bradley Randleman
1Emory University Department of Ophthalmology, Atlanta, Georgia, USA.
Journal of Cataract and Refractive Surgery
|February 5, 2008
Summary
Radial keratotomy (RK) patients are at risk for traumatic epithelial downgrowth years after surgery. Confocal microscopy definitively diagnoses this condition, aiding in management decisions.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Diagnostic Imaging
Background:
- Radial keratotomy (RK) is a refractive surgical procedure to correct myopia.
- RK involves incisions in the cornea, which can create long-term risks.
- Epithelial downgrowth is a rare but serious complication following ocular surgery.
Observation:
- A 40-year-old male with a history of bilateral RK presented with pain and photophobia after ocular trauma.
- Clinical examination revealed a deep stromal lesion, unresponsive to antibiotics.
- Confocal microscopy identified epithelial cells within the deep stroma and on the endothelial surface.
Findings:
- Confocal microscopy provided definitive evidence of epithelial downgrowth.
- Resolution of symptoms and lesion stability were observed after cessation of all medications.
- The case highlights the risk of late-onset epithelial downgrowth after RK.
Implications:
- Radial keratotomy incisions pose a long-term risk for traumatic epithelial downgrowth.
- Confocal microscopy is a valuable tool for diagnosing epithelial downgrowth.
- The management of epithelial downgrowth following refractive surgery remains a clinical challenge.
