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Vera-Duarte GR, Guerrero-Becerril J, Müller-Morales CA, Ramirez-Miranda A, Navas A, Graue-Hernandez EO. Delayed-onset pressure-induced interlamellar stromal keratitis (PISK) and interface epithelial ingrowth 10 years after laser-assisted in situ keratomileusis. Am J Ophthalmol Case Rep 2023; 32:101874. [PMID: 38161519 PMCID: PMC10757168 DOI: 10.1016/j.ajoc.2023.101874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/23/2023] [Accepted: 06/11/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose To report a case of pressure-induced interlamellar stromal keratitis (PISK) 10 years after laser assisted in situ keratomileusis (LASIK). Observations A case of a 36-year-old man who underwent LASIK and presented with PISK 10 years later. Before presenting to our department he consulted elsewhere for red eye, decreased visual acuity, foreign body sensation, and pain on the RE for 1 week. He was then prescribed topical prednisolone six times per day and was lost to follow-up. On examination and after 1 month of continuous use of steroids uncorrected distance visual acuity (UCDV) was 20/400 in the right eye (RE) and 20/20 in the left eye (LE). Best corrected visual acuity was 20/80 on the RE. The Goldmann intraocular pressure (IOP) was 26 and 17 mmHg in the RE and LE, respectively. Slit lamp biomicroscopy revealed fluid in the interface and epithelial ingrowth. Fundoscopic examination results were normal in both eyes. Treatment was initiated with topical brimonidine tartrate 0.2%, timolol 0.5%, and dorzolamide 2.0% BID. Once the pressure was controlled the patient was scheduled for mechanical debridement of the epithelial ingrowth with significant improvement of UCVA (20/25). Conclusions Refractive surgeons should be aware of PISK as a potential complication of LASIK even years after the procedure. Intraocular pressure can be misleading, and diligent and careful examination are key to diagnosis and treatment of this potentially blinding complication.
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Affiliation(s)
- Guillermo Raul Vera-Duarte
- Instituto de Oftalmología Fundación Conde de Valenciana FAP, Department of Cornea, external disease and Refractive Surgery, Chimalpopoca 14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Jesus Guerrero-Becerril
- Instituto de Oftalmología Fundación Conde de Valenciana FAP, Department of Cornea, external disease and Refractive Surgery, Chimalpopoca 14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Carlos Adolfo Müller-Morales
- Instituto de Oftalmología Fundación Conde de Valenciana FAP, Department of Cornea, external disease and Refractive Surgery, Chimalpopoca 14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Instituto de Oftalmología Fundación Conde de Valenciana FAP, Department of Cornea, external disease and Refractive Surgery, Chimalpopoca 14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Alejandro Navas
- Instituto de Oftalmología Fundación Conde de Valenciana FAP, Department of Cornea, external disease and Refractive Surgery, Chimalpopoca 14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Enrique O. Graue-Hernandez
- Instituto de Oftalmología Fundación Conde de Valenciana FAP, Department of Cornea, external disease and Refractive Surgery, Chimalpopoca 14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
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Macriz-Romero N, Vera-Duarte GR, Guerrero-Becerril J, Chacón-Camacho OF, Astiazarán MC, Zenteno JC, Graue-Hernandez EO. Ophthalmic findings in patients with autosomal recessive lamellar ichthyosis due to TGM1 mutations in an isolated population. Int Ophthalmol 2023; 43:3659-3665. [PMID: 37542530 PMCID: PMC10504104 DOI: 10.1007/s10792-023-02774-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/22/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE To describe the ocular clinical characteristics of a group of Mexican patients with lamellar ichthyosis (LI) arising from TGM1 pathogenic variants. METHODS Ophthalmological exploration, pedigree analysis and genetic screening were performed in patients with an established clinical diagnosis of lamellar ichthyosis from families located in a small community in the Southeast of Mexico. RESULTS Nine patients with LI in five families were identified. There were six affected females. All patients (9/9) demonstrated eye lid abnormalities with eight patients showing lid margin abnormalities. Madarosis was present in only three individuals and corneal scarring was documented in two. All nine individuals carried biallelic TGM1 variants, either homozygously or as compound heterozygous. CONCLUSION Ocular anomalies are common in individuals with TGM1-related LI. The occurrence of a variety of private or rare mutations hampers the identification of a genotype-phenotype correlation for ocular anomalies in this disorder.
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Affiliation(s)
- Nicole Macriz-Romero
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Chimalpopoca #14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Guillermo Raul Vera-Duarte
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Chimalpopoca #14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Jesus Guerrero-Becerril
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Chimalpopoca #14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico
| | - Oscar Francisco Chacón-Camacho
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
- Iztacala Faculty of Superior Studies, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Mirena C Astiazarán
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Juan Carlos Zenteno
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
- Biochemistry Department, Faculty Medicine, National Autonomous University of Mexico, Mexico City, Mexico
- Rare Diseases Diagnostic Unit, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Chimalpopoca #14, Colonia Obrera, Cuauhtémoc, 06800, Mexico City, Mexico.
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