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Published on: February 15, 2019
Wessely immune rings following Keratorefractive Lenticule extraction: A case-based review
Stanislav Pushkar1, Asset Omirzak1, Igor Remesnikov2
1Department of Ophthalmology, Astana Vision Clinic, Astana, Kazakhstan.
Insights
Immune-mediated corneal infiltrates, mimicking infections, can occur after keratorefractive lenticule extraction (KLEx). Early recognition and corticosteroid treatment lead to excellent visual recovery without lasting issues.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Immunology
Background:
- Keratorefractive lenticule extraction (KLEx) is a refractive surgery procedure.
- Postoperative complications can arise, requiring careful diagnosis.
Purpose:
To describe two cases of immune-mediated corneal stromal infiltrates resembling Wessely immune rings following keratorefractive lenticule extraction (KLEx).
Observations:
The first patient developed bilateral peripheral ring-shaped stromal infiltrates on postoperative day four, raising initial concern for infectious keratitis. Negative microbiologic work-up and favorable response to corticosteroids confirmed an immune-mediated etiology. The second patient presented with a unilateral peripheral stromal infiltrate on postoperative day one, which resolved with topical and subconjunctival corticosteroid therapy. In both cases, visual acuity improved to 20/20 without long-term sequelae.
Conclusions And Importance:
Wessely immune rings may develop after KLEx, mimicking infectious keratitis in the early postoperative period. Prompt recognition and differentiation of immune-mediated reactions from infections are essential to avoid unnecessary antimicrobial therapy and achieve favorable visual outcomes.
