Facebook
Twitter
LinkedIn
Email
 |
Checking for direct PDF access through Ovid | |
Excerpt
A 25-year-old woman visited our clinic because of moderate pain and redness in both eyes for 3 years. She had recently been diagnosed with Thygeson's superficial punctate keratitis and had been treated with topical corticosteroids infrequently. Biomicroscopic evaluation revealed multiple gray-white epithelial lesions in both corneas. She was treated with topical acyclovir ointment four times a day. The lesions had diminished in size and number, and symptoms remitted 2 weeks after treatment.
Four months after the first visit, she reported no symptoms, and requested refractive surgery for the correction of her myopic errors of both eyes because of intolerance of contact lenses. The patient's preoperative refraction was −6.00 −0.50 × 180 in the right eye and −3.25 −2.00 × 180 in the left eye with best-corrected visual acuity of 20/20 in each eye. The patient underwent PRK for her right eye using the VISX STAR S3 excimer laser (VISX, Santa Clara, California). Five months later, she underwent LASEK on her left eye. Topical 0.3% ofloxacin and 0.1% fluorometholone were prescribed 4 times daily postoperatively for a month.
One month after the surgery on her left eye, uncorrected visual acuities were 20/20 in the both eyes. However, she began to complain of pain and discomfort in both eyes. On slit-lamp examination, several granular lesions were noted on the corneal epithelium of both eyes including the laser ablation zone (Fig. 1). We resumed topical steroids, and gradually the patient's symptoms and signs subsided.
The pathogenesis of Thygeson's superficial punctate keratitis is currently under evaluation. Many possible suggestions have arisen as to the cause of this disease including viral infection or immunologic inflammation. 2–4 Fite and Chodosh 1 suggested that laser ablation of the cornea of Thygeson's keratitis might remove the causative factors from the anterior stroma of cornea. However, our data shows that, similar to attempts of debridement of epithelium, 5 the removal of anterior stroma may be insufficient to alleviate the course of the inflammation in some patients with Thygeson's keratitis.
