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Fuchs' superficial marginal keratitis managed with circumferential marginal corneoscleral lamellar patch graft
Luis F Mejía1, Juan P Santamaría, Ana M Gaviria
1Cornea Service, Ophthalmology Department, CES University, Medellin - Colombia. lfmejia@lfmejia.com
Purpose:
To report a case of Fuchs' superficial marginal keratitis managed with circumferential marginal corneoscleral lamellar patch graft.
Methods:
Interventional case report.
Results:
A 34-year-old man presented with several years' history of ill-defined symptoms of binocular ocular irritation associated with vision loss, mostly in the left eye. A superior marginal corneal thinning was found at biomicroscopy of the left eye, with 2 finely vascularized descemetoceles, and a gray epithelial demarcation line without lipid infiltrates. The right eye was clinically normal. Anterior segment optical coherence tomography demonstrated an important corneal thinning from the 7 o'clock to 3 o'clock positions, without scleral involvement. A circumferential marginal corneoscleral lamellar patch graft was done involving 3 mm of sclera and 3 mm of cornea.
Conclusions:
Fuchs' superficial marginal keratitis is a rare entity, mostly affecting young adults. It should be considered part of a spectrum of corneal thinning disorders, together with Terrien's marginal degeneration. Definitive treatment with a marginal corneoscleral lamellar patch graft with or without conjunctival autograft is suggested.
