Reduction of hyperopia and astigmatism after superficial keratectomy of peripheral hypertrophic subepithelial corneal degeneration.

PURPOSE: To report the development of progressive hyperopia and astigmatism resulting from peripheral hypertrophic subepithelial degeneration which was treated with superficial keratectomy of the lesion.

METHODS

Case report.

RESULTS

A patient with peripheral hypertrophic subepithelial degeneration of both corneas was followed up for a 6-year period. During this time, the patient experienced a slowly progressive increase in hyperopia and astigmatism in both eyes. In the left eye, extension of the degeneration paracentrally resulted in significant hyperopia and astigmatism and a best spectacle-corrected visual acuity of 20/70. Superficial keratectomy was performed and resulted in a dramatic reversal of the hyperopic and astigmatic shift and a best spectacle-corrected visual acuity of 20/30.

CONCLUSIONS

Peripheral hypertrophic subepithelial corneal degeneration can result in progressive flattening of the central corneal topography in the involved meridians. This flattening can induce a significant hyperopic and astigmatic shift in refraction. This refractive change can be reversed with superficial keratectomy to remove the degeneration.