Corneal Myxoma Arising in a Patient With Repeated Phototherapeutic Keratectomies

Abstract

We report the clinical and pathologic findings of a corneal myxoma that was diagnosed in a cornea that had undergone phototherapeutic keratectomy (PTK). A corneal myxoma was identified in a full-thickness keratoplasty specimen obtained from a 51-year-old man with a history of a forceps injury to his right eye at birth. The patient had presented with corneal edema and bullous keratopathy, which was treated on 3 occasions with PTK, resulting in progressive, persistent milky-white clouding of the cornea. This represents the eighth case of corneal myxoma in the reviewed literature and the first described after PTK. Thorough histopathologic and ultrastructural analyses were conducted. The histochemical, immunohistochemical, and electron microscopic findings were consistent with previously reported corneal myxomas. Most of the reported myxomas arising in the cornea presented with a history of prior corneal disease or injury and showed absence or disruption of Bowman layer histopathologically, as was found in our patient. The pathogenesis of corneal myxomas involves a reactive process that requires an antecedent affliction, in contrast to the neoplastic mesenchymal histogenesis of myxomas characterized in other parts of the body.