Corneal iron lines after refractive keratoplasty

Area of Science:

• Ophthalmology
• Corneal Surgery
• Ocular Surface Disease

Background:

• Refractive keratoplasty is a surgical procedure to correct vision.
• Aphakia, the absence of the eye's lens, often requires keratoplasty.
• Pigmented corneal lines can indicate underlying ocular conditions.

Purpose of the Study:

• To investigate the occurrence and nature of a pigmented corneal epithelial line after refractive keratoplasty.
• To determine the cause of the pigmented line observed in post-keratoplasty patients.

Main Methods:

• Analysis of 55 patients who underwent refractive keratoplasty for aphakia correction.
• Clinical observation of pigmented corneal epithelial lines.
• Histopathologic examination of corneal tissue to identify the composition of the pigmented line.

Main Results:

• A pigmented corneal epithelial line was found in 23 of 55 patients (41.8%).
• In most cases, the line was adjacent to the keratectomy scar.
• Histopathology revealed iron (ferritin) deposition within basal corneal epithelial cells.

Conclusions:

• The pigmented line is an iron deposit in the corneal epithelium following refractive keratoplasty.
• Steep corneal curvature and altered topography may cause eyelid malapposition and tear film disturbances, leading to iron deposition.
• This finding highlights a potential complication or characteristic change after specific corneal surgeries.