Abstract:
PURPOSE:We report a patient with progressive idiopathic, nonulcerative, noninflammatory, avascular, bilateral, paracentral and peripheral corneal thinning monitored for 13 years. METHODS:Because of progressive corneal thinning, the patient underwent several surgical procedures, including an arcuate lamellar keratectomy with suturing, bilateral 15-mm diameter onlay lamellar corneoscleral epikeratoplasties, and removal of interface epithelial tissue. Over time, the keratolysis also thinned the donor stroma, requiring a lamellar tectonic graft. A biopsy was performed of the patient's cornea and conjunctiva, and the tissue was analyzed for proteolytic enzymes. RESULTS:Increased quantities of matrix metalloproteinases (57 and 63 kDa) were extracted from the patient's normal-appearing and abnormal corneal samples but not from adjacent conjuctiva and sclera or normal controls. This is the first reported case with these clinical and laboratory findings. CONCLUSION:A previously undescribed progressive idiopathic paracentral keratolysis is associated with increased quantities of matrix metalloproteinases. Clinical management requires tectonic corneal surgery.
journal_name
Corneajournal_title
Corneaauthors
Hagen KB,Waring GO 3rd,Johnson-Wint Bsubject
Has Abstractpub_date
1997-07-01 00:00:00pages
486-92issue
4eissn
0277-3740issn
1536-4798journal_volume
16pub_type
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