Phototherapeutic Keratectomy in Macular and Granular Dystrophy: Two-year Results

Atik, Burcu Kemer; Yıldırım, Yusuf; Sonmez, Orcun; Gümüş, Gülşah; Yıldız, Burçin Kepez; Ağca, Alper

doi:10.1080/08820538.2020.1778743

Cited by 3 publications

(13 citation statements)

References 17 publications

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“…Table 3 outlines the management strategies for various corneal dystrophies. 28–51 Several corneal dystrophies including FCD, PACD, CCDF, and PDCD are typically asymptomatic and do not require treatment. The table provides a broad overview of general treatment approaches rather than an exhaustive description of all possible treatments.…”

Section: Principles Of Managementmentioning

confidence: 99%

IC3D Classification of Corneal Dystrophies—Edition 3

Weiss,

Rapuano,

Seitz

et al. 2024

Cornea

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Purpose: The International Committee for the Classification of Corneal Dystrophies (IC3D) was created in 2005 to develop a new classification system integrating current information on phenotype, histopathology, and genetic analysis. This update is the third edition of the IC3D nomenclature. Methods: Peer-reviewed publications from 2014 to 2023 were evaluated. The new information was used to update the anatomic classification and each of the 22 standardized templates including the level of evidence for being a corneal dystrophy [from category 1 (most evidence) to category 4 (least evidence)]. Results: Epithelial recurrent erosion dystrophies now include epithelial recurrent erosion dystrophy, category 1 (COL17A1 mutations, chromosome 10). Signs and symptoms are similar to Franceschetti corneal dystrophy, dystrophia Smolandiensis, and dystrophia Helsinglandica, category 4. Lisch epithelial corneal dystrophy, previously reported as X-linked, has been discovered to be autosomal dominant (MCOLN1 mutations, chromosome 19). Classic lattice corneal dystrophy (LCD) results from TGFBI R124C mutation. The LCD variant group has over 80 dystrophies with non-R124C TGFBI mutations, amyloid deposition, and often similar phenotypes to classic LCD. We propose a new nomenclature for specific LCD pathogenic variants by appending the mutation using 1-letter amino acid abbreviations to LCD. Pre-Descemet corneal dystrophies include category 1, autosomal dominant, punctiform and polychromatic pre-Descemet corneal dystrophy (PPPCD) (PRDX3 mutations, chromosome 10). Typically asymptomatic, it can be distinguished phenotypically from pre-Descemet corneal dystrophy, category 4. We include a corneal dystrophy management table. Conclusions: The IC3D third edition provides a current summary of corneal dystrophy information. The article is available online at https://corneasociety.org/publications/ic3d.

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Section: Principles Of Managementmentioning

confidence: 99%

IC3D Classification of Corneal Dystrophies—Edition 3

Weiss,

Rapuano,

Seitz

et al. 2024

Cornea

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“…PTK has been shown to produce a good visual outcome in eyes with GCD, based on various case reports and series [ 9 , 41 , 60 , 61 ]. Nassaralla et al reported a good outcome of PTK, using the ablation depth of 110 μm, in two patients (in their 40s and 50s) with GCD.…”

Section: Granular Dystrophymentioning

confidence: 99%

“…Consequently, the deposition of abnormal proteoglycans in the stroma leads to decreased corneal transparency and decreased vision [ 99 , 100 ]. The onset of the disease is towards the end of the first decade of life, hence demanding treatment at a younger age compared to the other dystrophies [ 61 ]. It starts with an anterior fleck-like stromal haze in the centre of the cornea.…”

Section: Macular Dystrophymentioning

confidence: 99%

“…Nevertheless, the recurrence is almost definite after a few months to years. Significant recurrence, which is defined and widely accepted as a drop of two or more lines on a Snellen chart or showing more than three episodes of pain, photophobia, tearing, or redness related to the original disease [ 32 , 62 ], is reported at 18 months [ 102 , 103 ] and 26 and 40 months [ 61 ] post-procedure in patients with MCD after undergoing PTK.…”

Section: Macular Dystrophymentioning

confidence: 99%

“…Visual acuity improved to 6/9, but the disease recurred significantly 18 months later, so the patient was offered penetrating keratoplasty [ 102 ]. Kemer et al published the outcome of augmented PTK in 14 eyes with MCD, two of which experienced significant recurrence 26 and 40 months later [ 61 ].…”

Section: Macular Dystrophymentioning

confidence: 99%

See 2 more Smart Citations

Management of Stromal Corneal Dystrophies; Review of the Literature with a Focus on Phototherapeutic Keratectomy and Keratoplasty

Ashena

Niestrata

Tavassoli

2023

Vision

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Corneal dystrophies are a group of non-inflammatory inherited disorders of the cornea. This review considers treatment options for epithelial-stromal and stromal corneal dystrophies: namely Reis–Bücklers, Thiel–Behnke, lattice, Avellino, granular, macular and Schnyder corneal dystrophies. Where there is visual reduction, treatment options may include either phototherapeutic keratectomy (PTK) or corneal transplantation. Due to the anterior location of the deposits in Reis-Bücklers and Thiel–Behnke dystrophies, PTK is considered the treatment of choice. For lattice, Avellino, granular and macular corneal dystrophies, PTK provides temporary visual improvement; however, with recurrences, repeat PTK or a corneal transplant would be needed. For Schnyder dystrophy, should treatment be required, PTK may be the preferred option due to the potential for recurrence of the disease in corneal transplantation. This review discusses the literature and evidence base for the treatment of corneal dystrophies in terms of visual outcomes and recurrence rate.

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Visual outcomes and recurrence rate of macular corneal dystrophy following phototherapeutic keratectomy in Saudi Arabia

AlHilali,

Jomar,

Albalawi

2023

Saudi Journal of Ophthalmology

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PURPOSE: The purpose of the study was to evaluate the visual outcomes and recurrence rate of patients with macular corneal dystrophy (MCD) who have undergone phototherapeutic keratectomy (PTK). METHODS: This retrospective, single-centered study enrolled patients from King Khaled Eye Specialist Hospital who had undergone PTK for MCD between 2000 and 2020. Pre-, intra-, and post-operative data were collected, and the primary outcome measures included uncorrected visual acuity, best-corrected visual acuity (BCVA), spherical equivalent, central keratometry, keratometric astigmatism, recurrence rate, and necessity of subsequent surgery. RESULTS: This study evaluated 42 eyes of 29 patients. BCVA improved from 0.41 (±0.17) preoperatively to 0.30 (±0.16) postoperatively. Sixteen out of 42 eyes (38%) had the recurrence of macular dystrophy deposits within the stroma; the average time from PTK to recurrence was 37 months (range: 5.5–115.4 months). The overall success rate of PTK at 2 years was 44.8%. Eleven eyes (26%) required subsequent surgery following PTK at an average of 43 months postoperatively. Deeper ablation and longer application of mitomycin C (MMC) were both found to be statistically significant factors associated with visual improvement and lower recurrence rate following PTK. CONCLUSION: PTK can be considered a treatment modality for younger patients to defer keratoplasty to a later stage. Deeper ablation is associated with improved postoperative visual acuity, and longer application of MMC is associated with lower recurrence rates of MCD.

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Phototherapeutic Keratectomy in Macular and Granular Dystrophy: Two-year Results

Cited by 3 publications

References 17 publications

IC3D Classification of Corneal Dystrophies—Edition 3

IC3D Classification of Corneal Dystrophies—Edition 3

Management of Stromal Corneal Dystrophies; Review of the Literature with a Focus on Phototherapeutic Keratectomy and Keratoplasty

Visual outcomes and recurrence rate of macular corneal dystrophy following phototherapeutic keratectomy in Saudi Arabia

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