Comparative biometric analysis of atypical peripheral corneal keloid-like lesions based on previous refractive surgery history

초록

Purpose : To compare the changes of biometric parameters through natural course in atypical peripheral corneal keloid-like lesions based on previous refractive surgery history. Methods : Medical records of 14 eyes of 10 patients were retrospectively reviewed. 6 cases of bilateral peripheral hypertrophic subepithelial corneal degeneration (PHSCD) without previous ocular history (Naïve group) and 8 cases of newly-developing peripheral corneal keloid like lesion following refractive surgery (Refractive group) were compared using collected ocular data. Changes of size, visual acuity, and corneal astigmatism between the first and the last visit were evaluated. Size progression rate was calculated as enlarged area (%) proportion to total corneal area and compared. Results : In corneal keloid cases with previous refractive surgery, the lesion occurred after 11.3 ± 6.6 years after the refractive surgery. Average follow-up was longer in naïve group (76.0 months) than in refractive group (24.6 months). There were no differences between two groups in best corrected visual acuity (BCVA), keratometric power, corneal astigmatism, and corneal irregularity index in both center 3 and 5mm at their last visit. Size of the lesion per whole corneal area was significantly larger in naïve group (21.7±4.2%) than in refractive group (8.7±1.2% in, p=0.03), while size progression rate between two groups showed no difference. Changes in BCVA and corneal astigmatism showed no difference between two groups, while change in corneal keratometric power showed significant difference between two groups (+0.1±0.1D in naïve group, -0.1±0.1D in refractive group, p=0.04). Conclusions : It suggests that corneal lesion size and subsequent change of the corneal flattening may be larger in naïve corneal keloid-like lesions, whereas progression rate would not be different between in naïve and in post-refractive corneal keloid-like lesions.