Superficial keratectomy and conjunctival autograft for Fuchs' superficial marginal keratitis

Purpose. To describe a patient with bilateral, recurrent marginal corneal i nfiltrates consistent with Fuchs' superficial marginal keratitis who develo ped bilateral nasal pseudopterygia encroaching on the visual axis, reducing visual acuity in both eyes. Methods. Bilateral superficial keratectomy com bined with conjunctival autografting was performed in each eye. Results. Be st corrected visual acuity improved from 20/60 in the left eye and 20/40 in the right eye to 20/25 in both eyes. Our patient has had no disease relaps es in her right eye, as of 29 months after the surgery, but experienced a m ild flare-up of marginal keratitis in her left eye 8 months after the surge ry. Despite this flare-up, disease symptoms in the left eye have markedly d iminished. Conclusion, Superficial keratectomy combined with conjunctival a utograft is a therapeutic alternative in the management of severe, recurren t Fuchs' superficial marginal keratitis. In the present case, it has result ed in an improvement in visual acuity as well as a decrease in the frequenc y of disease flare-ups. The clinical course of this patient suggests that t he conjunctiva may play a role in the etiology of Fuchs' superficial margin al keratitis.