라식수술 후 각막켈로이드의 국내 증례 1예
Corneal Keloid Case after Laser-assisted in-situ Keratomileusis Surgery in Korea
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목적: 라식수술 후 각막켈로이드를 진단하여 이를 보고하고자 한다. 증례요약: 41세 여자 환자로 15년 전에 라식수술을 받고 7년 후 우안 각막 하측 주변부에서 발견된 후 점점 커지는 하얀색 각막종괴를 주된 소견으로 내원하였다. 최대교정시력은 우안 0.6, 좌안 0.7이었으며, 전안부검사에서 우안 각막 5시 방향에 하얀색의 융기된 혼탁이 관찰되었다. 전안부 빛간섭단층촬영검사에서 종괴가 상층 기질과 상피에 침범되어 있고 보우만막이 파괴되어 있는 것을 확인할 수 있었다. 병리조직검사에서 방추 모양의 섬유아세포와 모양이 흐트러진 콜라겐들이 증식되어 있는 소견을 보였다. 이 결과들을 종합해 보았을 때 각막켈로이드로 진단할 수 있었다. 결론: 각막켈로이드는 매우 드문 질환이며, 라식 후 발생한 각막켈로이드는 아직까지 국내 보고가 없었다. 저자들은 라식 후 생긴 각막켈로이드를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Purpose: We report a patient diagnosed with corneal keloid who had laser-assisted in-situ keratomileusis (LASIK). Case summary: A 41-year-old female presented with LASIK 15 years ago. Seven years later, she presented with a growing white corneal mass located in the lower periphery of the right cornea. The best-corrected visual acuity was 0.6 in the right eye and 0.7 in the left eye, and the white lesion was observed in the right cornea at the 5 o’clock position. Anterior segment optical coherence tomography revealed that the mass was invaded by the upper stroma and epithelium, and Bowmans’s membrane was destroyed. Histopathologic examination showed fusiform fibroblasts and disorganized collagen. Taken together, these findings suggested corneal keloids. Conclusions: Corneal keloids is a rare disease that develops, sometimes, after LASIK surgery. Although there have been cases of this reported in the literature, there had yet to be a case of LASIK-induced corneal keloids in Korea until this study, reported here.
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