May 2006
Volume 47, Issue 13
ARVO Annual Meeting Abstract  |   May 2006
Post–Keratoplasty Atopic Sclerokeratitis
Author Affiliations & Notes
  • M. Tomita
    Ophthalmology, Tokyo Dental College, Ichikawa, Japan
  • S. Shimmura
    Ophthalmology, Keio University School of Medicine, Tokyo, Japan
  • Y. Satake
    Ophthalmology, Tokyo Dental College, Ichikawa, Japan
  • K. Tsubota
    Ophthalmology, Keio University School of Medicine, Tokyo, Japan
  • J. Shimazaki
    Ophthalmology, Tokyo Dental College, Ichikawa, Japan
  • Footnotes
    Commercial Relationships  M. Tomita, None; S. Shimmura, None; Y. Satake, None; K. Tsubota, None; J. Shimazaki, None.
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 3588. doi:
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      M. Tomita, S. Shimmura, Y. Satake, K. Tsubota, J. Shimazaki; Post–Keratoplasty Atopic Sclerokeratitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3588.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Severe sclerokeratitis in atopic dermatitis patients following keratoplasty was recently identified as post–keratoplasty atopic sclerokeratitis (PKAS). The purpose of this study is to report the incidence of patients diagnosed with PKAS at our institution.

Methods: : We investigated the medical records of post–keratoplasty keratoconus patients at Tokyo Dental College Ichikawa General Hospital, Japan between May 2000 and December 2004. We recorded the incidence of PKAS, patients’ age, sex, systemic complications, timing of developing, slit examination, treatment, and prognosis.

Results: : A total of 203 keratoconus eyes were followed at our clinic following keratoplasty, of which 5 eyes of 4 cases with severe atopic dermatitis developed PKAS. Mean age of PKAS patients was 29.5 (23–39) years old, 3 cases were male and 1 case was female. One case had asthma and 2 cases had diabetes mellitis. The mean period between keratoplasty and onset of PKAS was 25 (11–41) days. Loosening of running sutures and wound leakage was observed in 3 eyes, persistent epithelial defects (PED) in 3 eyes, graft melting in 2 eyes of which 1 eye perforated. Treatment consisted of systemic corticosteroids, cyclosporin, amniotic membrane patches and regrafting.

Conclusions: : PKAS is a potentially severe complication in atopic patients undergoing keratoplasty. Systemic immunosuppression and interrupted sutures should be considered in cases with a risk of PKAS.

Keywords: keratoconus • transplantation • clinical (human) or epidemiologic studies: outcomes/complications 

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