잘쯔만결절변성으로 오인된 각막표층의 아밀로이드증의 치료 1예

Secondary Localized Corneal Amyloidosis as Misdiagnosed Salzmann’s Nodular Degeneration

Purpose: To report the clinical efficacy of amnionic membrane corneal graft combined with using grind ball in a case of secondary localized corneal amyloidosis as clinical misdiagnosed saltzmann nodule. Case summary: A 64-year-old man with intermittent ocular pain and decreased visual acuity in left eye visited our clinic. In the first visit, the best corrected visual acuity (BCVA) in left eye was finger count and ocular pressure in left eye was 15 mmHg. The neovascularization from temporal side of the limbus to central corneal nodules was observed and was formed to a pannus. He had surgery on corneal lesion, removed corneal nodules by superficial keratectomy and trimmed the irregular corneal surface using grind ball and then transplanted amniotic membrane. A removed corneal tissue of the lesion was examined by immnohistochemistry and the tissue was stained positively with Congo red. No systemic involvement was noted form systemic work-up. Secondary localized amyloidosis of the cornea was diagnosed. After surgery for 3 month, the BCVA was 20/100 in left eye and there was no complications and recurrence on the corneal lesion at 11 month after surgery. Conclusions: It should be considered as one of useful therapeutic technique for management of superficial corneal amyloidosis by removing the lesion through superficial keratectomy, and then trimming and smoothing the irregular corneal surface using grind ball and transplanting the amniotic membrane.