ABSTRACT
Purpose: To report clinical features and treatment outcome of three cases with isolated corneal intraepithelial neoplasia (CIN). Methods: This case series presents 3 patients with isolated CIN. Data collected included, presenting signs and symptoms including vision, anterior segment examination, medical and surgical outcomes and signs and symptoms at lost post-treatment visit. Results: Case 1 was a 45-year-old male who presented with an isolated grayish amoeboid corneal lesion which was excised with alcohol assisted epitheliectomy, he also received 6 cycles of topical mitomycin C (MMC) 0.02% and one injection of interferon alfa-2b with no recurrence during the 10-year follow-up period. Case 2 was 78-year-old male referred for a suspicious white corneal lesion which was completely excised, the patient also received 6 subconjunctival injections of interferon alpha-2b. However, the lesion recurred at 2.5-years post-treatment. Case 3 was a 63-year-old male patient who presented with an isolated corneal lesion that was excised using alcohol-assisted epitheliectomy, patient received four cycles of topical 5-fluorouracil with no recurrence at last follow-up visit at 6 months. Conclusion: Isolated corneal intraepithelial neoplasia (CIN) is a rare entity with few reported cases in the literature. In this case series, we report long and short-term management outcomes of combined surgical and medical therapy for isolated CIN.
ABSTRACT
PURPOSE: To examine the incidence, causes, characteristics, and the visual outcome of traumatic wound dehiscence (TWD) after penetrating keratoplasty (PK) compared to lamellar keratoplasty (LKP) for keratoconus. METHODS: The medical records of all keratoconus patients undergoing TWD repair after PK or LKP over a 7-year period at the King Khaled Eye Specialist Hospital (KKESH), Riyadh were reviewed. Data were collected on patient demographics, interval between keratoplasty and trauma, and characteristics and visual outcomes of TWD. RESULTS: During January 2006 to December 2012, 2863 eyes in KKESH underwent PK. Another 1716 eyes underwent LKP. Of these, 55 (1.9%) and 30 (1.7%) sustained TWD, respectively (p = 0.675). Approximately two-thirds of patients with traumatic wound dehiscence (TWD) were males in both groups (63.6% and 70.0%, respectively). The mean age at trauma was 24.6 ± 6.7 years (range 12-41 years) in the PK group compared with 22.6 ± 6.0 years (range 13-34 years) in the LKP group (p = 0.166). The median interval between keratoplasty and trauma was 6.2 (the interquartile range (IQR), 10.9) months for the PK group and 4.6 (IQR, 7.4) months for the LKP group (p = 0.116). At the last follow-up after wound repair, visual acuity was similar between the PK and LKP groups (p = 0.595). CONCLUSION: In our study, the incidence of TWD after PK and LKP in patients with keratoconus was within the previously reported range of values. All patients undergoing these procedures, especially males, should receive adequate information regarding this lifelong risk, and the need for protective eye-wear and seeking early medical advice when complications occur.
