Uncommon Giant Corneal Keloid: A Case Report and Literature Review

Abstract Background: Corneal keloid is a rare kind of clinical disease. Surgery is the only treatment in the end, but the literature reports vary. This is a case study of the diagnostic and treatment course for a patient with giant corneal keloid.Case presentation: A 36-year-old young man was admitted to the hospital because of a large mass on the surface of the left cornea. A slit lamp examination revealed that the lesion covered the entire cornea and protruded from the surface of the eyeball, so that the left eyelid could not be closed normally. B-scan of the eye showed that the internal structure of the left eye was normal. The mass was surgically removed and send for pathological examination, and then the ocular surface reconstruction was taken by deep anterior lamellar keratoplasty. Histopathologic study showed irregular epithelium, the absence of Bowman’s layer and hyperplastic collagen fibers, which are consistent with the diagnosis of corneal keloid. Immunohistochemical revealed positive staining for vimentin in lesion subject and smooth muscle actin (SMA) in vascular wall. The corneal graft remained clear 4 months after surgery and the patient was satisfied with the visual outcome. A final diagnosis of giant corneal keloid was reached.Conclusion: Corneal keloid should be suspected in cases of enlarging white glistening corneal nodule after trauma. Deep anterior lamellar keratoplasty is one of the effective surgical option for corneal keloids.