Abstract
To evaluate the visual outcomes, recurrence patterns, safety, and efficacy of excimer laser phototherapeutic keratectomy (PTK) in conjunction with mitomycin C (MMC) for corneal macular and granular diystrophies. The patients were divided into two groups. Group 1 included patients with macular corneal dystrophy (MCD) that caused superficial corneal plaque opacities, and Group 2 included patients with granular corneal dystrophy (GCD). Patients in both groups were pre-, peri-, and postoperatively evaluated. The groups were compared in terms of uncorrected visual acuity (VA), best spectacle-corrected VA, presence of mild or significant recurrence, and time of recurrence. Eighteen eyes (nine with MCD and nine with GCD) of 18 patients (10 men and eight women) were included. PTK was performed for each eye that was included in this study. The mean ablation amount was 117.8 ± 24.4 µm and 83.5 ± 45.7 µm in MCD and GCD, respectively, (p=0.18). The postoperative improvement of the mean VA was similar between the two groups before recurrences (p>0.43) and after recurrences (p>0.71). There were no statistically significant differences in the recurrence rate and the recurrence-free period for any recurrence type. PTK was an effective, safe, and minimally invasive procedure for patients with MCD and GCD. PTK in conjunction with MMC was similarly effective for both groups in terms of recurrence and visual outcomes.
Highlights
Phototherapeutic keratectomy (PTK), approved by the Food and Drug Administration in 1995, is popularly used for treating anterior corneal dystrophies[1]
Os grupos foram comparados em termos de acuidade visual (VA) não corrigida, visual acuity (VA) melhor corrigida por óculos, presença de recorrência leve ou significativa e o tempo de recorrência
Macular corneal dystrophy (MCD) is a rare stromal dystrophy that is characterized by superficial gray-white opacities and corneal thinning, which progressively involves the entire stroma from limbus to limbus[3]
Summary
Phototherapeutic keratectomy (PTK), approved by the Food and Drug Administration in 1995, is popularly used for treating anterior corneal dystrophies[1]. Corneal stromal dystrophies are progressive diseases that appear in adolescence or later[2,3] and usually cause blurry vision and sometimes symptoms of recurrent erosions[2,3]. Macular corneal dystrophy (MCD) is a rare stromal dystrophy that is characterized by superficial gray-white opacities and corneal thinning, which progressively involves the entire stroma from limbus to limbus[3]. While MCD is a recessively inherited dystrophy, granular corneal dystrophy (GCD) is a slowly progressive autosomal dominant disorder that is characterized by deposits at different depths in the corneal stroma[5,6]. Mitomycin C (MMC), an alkylating agent, is commonly used in refractive excimer laser surgery to regulate corneal wound healing; it is believed that MMC can prevent or delay recurrence of the disease in corneal dystrophies[9,10,11]
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