Treatment of Refractory Filamentary Keratopathy After LASIK With Autologous Serum Tears
Purpose
The aim of this study was to review the pathogenesis and treatment of filamentary keratopathy.
Methods
Patient chart review including anterior segment optical coherence tomography and pathological specimens using basic histological staining.
Results
The patient developed filamentary keratopathy following refractive surgery. Pathology showed filaments composed of a central epithelial core surrounded by inflammatory cells and mucus. The patient was treated with mechanical filament removal, artificial tears, bandage contact lens placement, topical anti-inflammatory medication and oral doxycycline. However, he continued to have filament recurrence after two months of treatment and was subsequently started on autologous serum tears with resolution of keratopathy one week later.
Conclusion
Filament formation is a multifactorial process involving inflammation, aqueous tear deficiency and microtrauma from anatomical factors. Current treatment strategies are used to target the various etiologies of filament pathogenesis. This is the first study showing the efficacy of autologous serum tears in the treatment of refractory filamentary keratopathy.