A 75-year-old male diagnosed with primary bilateral lipoid keratopathy complaining of progressive loss of visual acuity (VA).
The/60 exploration revealed a VA of 20 in right eye (OD) and left eye (LE) hand movement.
The biomycosis showed an incomplete annular white-yellow corneal opacity throughout the stroma thickness, respecting the visual axis in the right eye and affecting the central cornea in the left eye.
Superficial and deep neovascularization extending to the center of the cornea was also observed.
Serum lipid levels were normal.
She underwent surgery, performing a penetrating keratoplasty extracting extra cataract and intraocular lens implantation in the left eye.
Postoperative treatment included topical steroids and antibiotics: 4 times/day (Tobradex®, Alcon-Cusí, Barcelona, Spain), 2% topical cyclosporine: 4 times/day, and oral prednisone: 50mg/day, in
1.
One month later, the biomycosis revealed deep corneal neovascularization extending over the bed and the graft-host interface at 3 and 6 hours, with a whitish opacity around the vessels.
After obtaining informed consent for compassionate use of medication, topical treatment with beizumab (25mg/ml) was initiated: 4 times/day/2 months, on a descending regimen for 6 months.
At 8 months, the patient was maintained on topical beizumab once daily.
1C shows partial regression of corneal neovascularization with transparent graft.
His VA was 20/40.
