Korean J Ophthalmol.  2005 Jun;19(2):156-159. 10.3341/kjo.2005.19.2.156.

A Case of Congenital Corneal Keloid

• Song JS
• Kwon S
• Shyn KH

• KMID: 754417
• DOI: http://doi.org/10.3341/kjo.2005.19.2.156

Abstract

PURPOSE
To describe a case of unilateral corneal keloid and present the clinical and histopathological findings and the management. METHODS: A 23-year-old Asian male patient was examined for a white spot on the left cornea that had been present since birth. On biomicroscopic examination, a well-demarcated vascularized corneal mass was found located nasal to the center. The pupil was displaced superiorly, and gonioscopic examination showed peripheral iridocorneal adhesion at 12 o'clock. The patient underwent penetrating keratoplasty. RESULTS: Histopathologic study showed a variously thickened epithelial layer, an absence of Bowman's layer, subepithelial fibrovascular hyperplasia, and an absence of dermal elements. These histopathologic findings suggested a congenital corneal keloid. The central graft cornea remained clear at 18 months after surgery and the patient was satisfied with the result. CONCLUSIONS: Penetrating keratoplasty may be an effective surgical option for congenital keloids in young adult patients.

Keyword

Corneal opacity; Histopathology; Keloid; Penetrating keratoplasty; White spot

MeSH Terms

Adult
Corneal Diseases/*congenital/*pathology/surgery
Humans
Keloid/*congenital/*pathology/surgery
Keratoplasty, Penetrating
Male

Figure

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  Fig. 1 (A) A well-demarcated vascularized round mass is located slightly nasal to the center on the left cornea. (B) Gonioscopic examination shows peripheral iridocorneal adhesion at 12 o'clock.

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  Fig. 2 Anterior segment fluorescein angiographic findings. (A) A single large vessel supplying the mass lesion appears in the early period. (B) Profuse leakage from the vascular network within the mass is shown in the late period.

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  Fig. 3 Light microscopy of the mass (hematoxylin and eosin staining) shows a variously thickened epithelial layer, subepithelial fibrovascular proliferation, an absence of Bowman's layer, and irregularly arranged collagen fibers (original magnification, ×40).

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  Fig. 4 Slit-lamp photograph shows small opacities along with corneal sutures and a moderately sized leukoma at the 3 o'clock position. The central cornea remained clear at the last follow-up at 18 months after surgery.

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