Granular corneal dystrophy recurrence at the posterior graft-host interface after type 1 big bubble deep anterior lamellar keratoplasty

Abstract

Purpose To describe our observations of granular corneal dystrophy (GCD) recurrence isolated to the posterior graft-host interface after type 1 big bubble (BB) deep anterior lamellar keratoplasty (DALK). Observations We performed a retrospective chart review of 3 eyes in 2 patients, and literature review to summarize GCD recurrence patterns after DALK. A 29-year-old man with GCD underwent DALK by type 1 BB technique. Three years following surgery, he was found to have recurrence of GCD deposits isolated to the posterior graft-host interface. Similarly, a 53-year-old woman with GCD underwent DALK by BB type 1 technique, and was noted to have trace residual deposits at the posterior graft-host interface that increased in number and size over the course of 6 years. Her fellow eye underwent DALK with type 2 BB formation, without evidence of graft-host interface recurrence over a four year period. Our literature review describes the recurrence patterns of 18 cases of GCD following DALK. Conclusions and importance DALK can be prone to GCD recurrence in the central posterior graft-host interface. Recurrent deposits isolated to the posterior graft-host interface following type 1 BB DALK supports the hypothesis that GCD recurrence may be due to residual pathologic keratocytes in the pre-Descemet layer (PDL).

Long-Term Observation of Deep Anterior Lamellar Keratoplasty in Patients with Post-LASIK Granular Corneal Dystrophy Type 2: Two Case Reports

“…In contrast, the surgeon cleaved a plane between the Descemet membrane and corneal stroma in the left eye. Corneal opacities recurred only in the right eye at 6 years after surgery [10]. In our patient, exposure of the Descemet membrane without preservation of the corneal stroma presumably prevented recurrent corneal opacity during long-term follow-up.…”

“…In our patient, exposure of the Descemet membrane without preservation of the corneal stroma presumably prevented recurrent corneal opacity during long-term follow-up. Considering that the mean duration of GCD recurrence after DALK in the literature was 2.4 years (19 cases, range: 0.5 to 8.5 years) [10], our follow-up duration might be sufficient.…”

“…Because keratocytes in the corneal stroma may be an important source of recurrent corneal opacity in patients with GCD types 1 and 2 [10], we recommend that surgeons carefully remove the entire host corneal stroma during the treatment of patients with LASIK-aggravated GCD. This recommendation is consistent with a report by Oke et al that involved DALK with the big-bubble technique on both corneas of a patient with GCD.…”

Complications in deep anterior lamellar keratoplasty – A retrospective cross sectional interventional analysis in a large series

“…Until now 18 cases of recurrence in Granular corneal dystrophy have been recorded from 6 months to 8.5 months with varying patterns. [ 26 ] In our study, 2 eyes (0.41%) showed its recurrence hence, it becomes source of its incidence. A study conducted by Sogutlu Sari et al .…”

Complications in deep anterior lamellar keratoplasty – A retrospective interventional analysis in a large series

“…Until now, 18 cases of recurrence in granular corneal dystrophy have been recorded from 6 months to 8.5 months with varying patterns. [ 26 ] In our study, two eyes (0.42%) showed its recurrence; hence, it becomes a source of its incidence. A study conducted by Esin Sogutlu Sari et al .…”