OBJECTIVE: This study aimed to review the presenting features, treatment administered to,
histopathologic findings, and complications encountered in a cohort of patients with
atopic keratoconjunctivitis. DESIGN: The
study design was a
retrospective cohort series. PARTICIPANTS: The medical records of 20 patients with
atopic keratoconjunctivitis and a minimum follow-up of 3 years were reviewed. MAIN OUTCOME MEASURES:
Conjunctival and
corneal complications,
visual acuity before and after
surgery, and
histopathologic features on
conjunctival biopsy were measured. RESULTS: Significant keratopathy developed in 70% of patients,
corneal neovascularization in 60%, fornix foreshortening in 25%, and symblepharon in 20% during the course of their disease. Eleven patients (12
eyes) required
penetrating keratoplasty (3 for tectonic purposes and 8 for
visual rehabilitation). Vision improved by four or more lines of
Snellen acuity in four
eyes, improved by two lines in two
eyes, remained the same in five
eyes, and worsened by two lines in one
eye after
keratoplasty.
Cataract surgery was performed in seven patients (nine
eyes) with vision improving by four or more lines in six patients (eight
eyes). CONCLUSION:
Atopic keratoconjunctivitis is a potentially blinding disease that may result in a poor
visual outcome as a result of
corneal complications. Elective
surgical intervention may be of benefit and can be considered in those patients whose
inflammation is well controlled.
