FUCHS' SUPERFICIAL MARGINAL KERATITIS, CASE REPORT

To report two patients with clinical picture compatible with a diagnosis of bilateral Fuchs' superficial marginal keratitis treated with surgical treatment and anti-inflammatory drugs.

Retrospective interventional study

Two female cases suffered from bilateral photophopia, blurred vision and pseudopterygium with normal intraocular pressure (IOP). Pseudopterygia extending from the temporal and nasal sides and had a gray line between the corneal normal epithelium with no lipid deposits. The first case had bilateral high mixed astigmatic error and the second had dry eye symptoms. No abnormalities, including systemic inflammatory disease, were found in laboratory investigations. The first case had bilateral pseudopterygium excision, MMC application, and pedicled conjunctival flap transplantation. The patient was followed regularly and her condition was stable without any recurrence or deterioration in the ocular findings. The second case had conjunctival resection + amniotic membrane transplantation + MMC application 6 times on the right eye and 3 times on the left eye along 4 years and suffered recurrences after each operation. Her visual acuity had severely decreased with elevated IOP of both eyes.  The patient refused to do any further surgical intervention.

We encountered two cases where refractory peripheral corneal infiltration and pseudopterygia were present in both eyes, leading to a strong suspicion of FSMK. Despite its rarity, FSMK should be considered when peripheral corneal infiltration, corneal thinning, and pseudopterygia are observed in both eyes. Although treating this condition is challenging, timely surgical and anti-inflammatory interventions may help manage the disease.