Keratoconus with two consecutive re-emergences: a case report

Area of Science:

• Ophthalmology
• Corneal Surgery
• Genetics

Background:

• Keratoconus (KC) is a prevalent corneal disease.
• Deep anterior lamellar keratoplasty (DALK) is a standard surgical treatment for KC, known for its effectiveness and low recurrence rates.

Purpose of the Study:

• To report a rare case of consecutive re-emergences of keratoconus after multiple DALK procedures.
• To highlight the importance of managing associated conditions and patient habits in preventing KC recurrence.

Main Methods:

• A case report of a 21-year-old patient with keratoconus undergoing three DALK surgeries.
• Genetic testing was performed, revealing no identified gene abnormalities.
• Postoperative management included addressing chronic allergic conjunctivitis (CAC) and correcting eye-rubbing behaviors.

Main Results:

• The patient experienced three episodes of keratoconus re-emergence requiring repeat DALK procedures.
• Genetic analysis did not identify specific causative genes.
• Following targeted management of CAC and eye-rubbing, the patient has remained recurrence-free to date.

Conclusions:

• Keratoconus is a complex condition with diverse contributing factors, including genetics and environmental influences.
• Successful management of keratoconus, especially after recurrence, necessitates a comprehensive approach.
• This includes careful surgical technique selection, appropriate anti-inflammatory therapies, and patient education on habits like eye rubbing.