Sever Limbal Stem Cell Deficiency in Refractory Vernal Keratoconjunctivitis: A Case Report

Abstract

Purpose: Here we describe a case of severe and steroid-resistant limbal vernal keratoconjunctivitis with limbal papillary hypertrophy, total stem cell deficiency and its pattern of treatment. Methods: Case report. Results: The patient was a 21 years-old lady with a complaint of reduced vision, ocular surface burning and photophobia in both eyes since a many years ago. Her complains was aggravated since last year. Her past medical history was unremarkable. According to corneal impression cytology and incisional biopsy of the limbal hypertrophic lesions, the limbal vernal keratoconjunctivitis (VKC) with sever limbal stem cell deficiency had diagnosed. It was resistance to topical steroid therapy, therefore topical tacrolimus 0.05% improved her sign and symptoms and eventually the good visual acuity achieved with penetrating keratoplasty (PKP) and amniotic membrane transplantation (AMT) surgeries. Conclusion: The limbal mass like hypertrophy with total limbal stem cell deficiency may be the initial manifestation of VKC and should be considered in the differential diagnosis. In severe and