Chronically retained feathery chestnut-burr spine-related corneal injury: clinical features and outcome.

PURPOSE: To establish the clinical features and outcomes of patients with chronically retained, feathery chestnut-burr spine-related corneal injury. METHODS: The data of the patients who presented with chestnut-burr-related corneal injury between 2010 and 2018 were retrospectively evaluated. Nineteen eyes of 19 patients, with chronically retained corneal intrastromal feathery chestnut-burr spines, were included. RESULTS: The mean age of the patients (11 male and 8 female) was 29.8 +/- 19.9 years. Best-corrected visual acuity was 0.13 +/- 0.23 logMAR at initial examination and increased to 0.0 +/- 0.0 logMAR at last visit. Chestnut-burr spines were located in the peripheral cornea in 14 eyes (73.7%) and in the central cornea in 5 eyes (26.3%). Localized corneal edema surrounding the chestnut-burr spines were detected in all eyes. No eyes were Seidel positive. Three eyes (15.8%) had low-grade anterior chamber reaction. None of the patients had epithelial ulceration or any sign of infection at initial presentation. In order to control acute localized inflammation, all patients were put on topical steroid (loteprednol etabonate). The mean duration of topical steroid treatment was 3.8 +/- 1.8 (range 2-7) months. During the follow-up period, inflammation was controlled and no sign of reinflammation occurred. CONCLUSION: Acute inflammation in intrastromal chestnut-burr spines can be well controlled with easy tapering of topical steroids. However, as the reinflammation possibility cannot be excluded, long-term follow-up of these patients is mandatory.