Limbal Stem Cell Deficiency Following Phototherapeutic Keratectomy

Purpose. To describe a case of limbal stem cell (LSC) deficiency following phototherapeutic keratectomy (PTK). Methods. We analyzed the case of a 67-year-old man who developed LSC deficiency in his left eye following PTK for recurrent epithelial erosions. Predisposing factors included diabetes mellitus and rosacea. Results. Surgical treatment consisted of debridement of the diseased corneal epithelium, followed by limbal autografting from the fellow eye. The cornea healed and remained transparent after 1 year. Histologic examination confirmed the diagnosis of LSC deficiency, showing the presence of goblet cells and inflammatory cells within the epithelium. Conclusion. The extensive corneal mechanical debridement and laser photoablation incurred during phototherapeutic keratectomy can cause clinical LSC deficiency in patients with predisposing external diseases.

[1]  H. Dua The conjunctiva in corneal epithelial wound healing , 1998, The British journal of ophthalmology.

[2]  E. Holland,et al.  Iatrogenic Limbal Stem Cell Deficiency , 1998, Transactions of the American Ophthalmological Society.

[3]  K. Tsubota,et al.  Temporary corneal stem cell dysfunction after radiation therapy. , 1996, The British journal of ophthalmology.

[4]  S. Tseng,et al.  Cytologlogic Evidence of Corneal Diseases with Limbal Stem Cell Deficiency , 1995 .

[5]  S. Tseng,et al.  Cytologic evidence of corneal diseases with limbal stem cell deficiency. , 1995, Ophthalmology.

[6]  A Singh,et al.  Corneal epithelial wound healing. , 1994, The British journal of ophthalmology.

[7]  S. Tuft,et al.  Limbal transplantation in the management of chronic contact-lens-associated epitheliopathy , 1993, Eye.

[8]  J. Forrester,et al.  The corneoscleral limbus in human corneal epithelial wound healing. , 1990, American journal of ophthalmology.

[9]  J. Erie,et al.  Conjunctival and corneal intraepithelial and invasive neoplasia. , 1986, Ophthalmology.

[10]  C. Margo Congenital aniridia: a histopathologic study of the anterior segment in children. , 1983, Journal of pediatric ophthalmology and strabismus.