Corneal keloid: report of natural history and outcome of surgical management in two cases

Abstract

Purpose: To report the natural history and the outcome after the surgical management of 2 cases of corneal keloids.

Methods: Two male patients, 21 and 24 years old, with a history of corneal opacity for 5 and 17 years, respectively, with no history of an ocular trauma were studied.

Results: The first patient initially underwent a superficial keratectomy (SK), after which the corneal opacification recurred. He subsequently underwent 2 SK procedures combined with phototherapeutic keratectomy and mitomycin C, followed by a femtosecond laser-assisted deep anterior lamellar keratoplasty. The second patient underwent a bilateral SK followed by a penetrating keratoplasty in the left eye with the rapid recurrence of the lesion. The patient subsequently underwent an implantation of a Boston type 1 keratoprosthesis in the right eye, with a favorable outcome. The histopathologic features of both excised corneal specimens were consistent with the diagnosis of a corneal keloid.

Conclusions: Corneal keloids recur after SK and phototherapeutic keratectomy, indicating that keratoplasty procedures may be more effective than keratectomy procedures in their management. However, corneal keloids may recur even after a penetrating keratoplasty, in which case keratoprosthesis implantation represents a viable option for visual rehabilitation.