Late corneal perforation after photorefractive keratectomy associated with topical XXXX : involvement of matrix metalloproteinases.

@entity1 @entity6 @entity3522 @entity1476 @entity1549 @entity1495 @entity1413 @entity792
OBJECTIVE: To report a case of a 50-year-old @entity1 who was initially seen with a corneal perforation in his right eye 2 months after a photorefractive keratectomy (PRK) procedure and to discuss the roles of topical @entity3522 and matrix metalloproteinases (MMPs). DESIGN: Case report with tissue analysis. MAIN OUTCOME MEASURES: Ocular examination, diagnostic workup, surgical treatment, and histologic, immunofluorescent, zymography, and real time-polymerase chain reaction studies on corneal button. RESULTS: Slit-lamp examination of the right eye revealed a 4-mm diameter area of central corneal thinning with a 2-mm diameter perforation at its center. Predisposing factors included prolonged postoperative topical @entity3522 therapy for more than 2 months and a 10-year history of well-controlled @entity6 . An extensive diagnostic workup ruled out a @entity792 . A penetrating keratoplasty was performed. Results of immunohistochemical studies of the corneal button showed stromal accumulation of @entity1413 , @entity1549 , and @entity1495 in the anterior wounded stroma and @entity1495 in the basal corneal epithelial cells of the leading edge. Differential activity and expression of @entity1476 and @entity1495 were found between the central and peripheral corneal buttons. CONCLUSIONS: Prolonged use of @entity3522 and @entity6 might be responsible for the corneal perforation after PRK in our @entity1 . @entity1495 and @entity1549 might be involved in delayed wound closure and corneal melting.
