Deep Anterior Lamellar Keratoplasty as an Alternative Treatment on Granular Corneal Dystrophy

Abstract

Introduction: Granular corneal dystrophies (GCD) is an autosomal dominant corneal disorder with bilateral visual disturbances. Deep anterior lamellar keratoplasty (DALK) was recently introduced as an alternative to keratoplasty. This case report mentions DALK as treatment modality for management of young patient with GCD. Case Report: A 24-year old Indonesian man presented with bilateral progressive visual loss since he was fifteen years of age. His bilateral best visual acuity was half meter finger counting. Slit lamp examination on both eyes revealed diffuse hazy corneas with bilateral opacities and multiple granular Bowman's plane and anterior half of stroma. The patient was diagnosed as having a granular corneal dystrophy of both eyes and DALK was performed with manual lamellar dissection technique on his right cornea. The same size of donor cornea was triphaned 1/2 depth and put on top of host bare cornea, then nylon 10-0 was sutured. Two week after procedure, best corrected visual acuity in right eye improved to 6/40. Conclusion: DALK is an alternative procedure for management of patients with GCD whose corneal endothelium is not compromised.