A case of noninflammatory corneal edema following anterior-posterior radial keratotomy (Sato's operation) successfully treated by topical corticosteroid

Background: Corticosteroids seem to affect the functions of corneal endothe lial cells directly in addition to their anti-inflammatory effect. Case: A 69-year-old man presented with blurred vision in his left eye and d ecreased visual acuity in both eyes. He had received anterior-posterior rad ial keratotomy for myopia in both eyes 40 years earlier. Observations: Both eyes showed mild corneal stromal edema in the pupil area . We diagnosed the condition as corneal edema secondary to cell loss and dy sfunction of corneal endothelium after surgery. One month later, the stroma l edema was further advanced in the left eye. Corneal thickness had increas ed from the initial value of 619 mu m to 631 mu m, and corrected visual acu ity had decreased from 0.5 to 0.06. There were no signs suggesting inflamma tory reaction. The left eye was then treated with topical corticosteroid ey edrops and subconjunctival corticosteroid injection. Two months later, corn eal thickness had decreased to 546 mu m and visual acuity had improved to 0 .5. Conclusions: This case shows that topical corticosteroids may be effective in treating corneal edema by producing an anti-inflammatory effect and poss ibly activating the endothelium. (C) 2000 Japanese Ophthalmological Society .