Recurrence of Granular Corneal Dystrophy Type 1 After Phototherapeutic Keratectomy, Lamellar Keratoplasty, and Penetrating Keratoplasty in a Single Population.

Abstract

To describe the recurrence of granular corneal dystrophy type 1 (GCD1) after penetrating keratoplasty (PKP), anterior lamellar keratoplasty (ALK), deep anterior lamellar keratoplasty (DALK), and phototherapeutic keratectomy (PTK) in a single population. The time required to achieve best-corrected visual acuity (BCVA) after each intervention was also analyzed. Retrospective review of all patients with GCD1 from a single center between 1989 and 2016. Surgical interventions were performed 50 times on 28 eyes of 15 patients. Data were primarily analyzed through Cox regression modeling with clustering and robust log-rank testing. Significant recurrence occurred most rapidly after PTK (median time 2.7 years) and was most delayed after PKP (13.7 years). Significant recurrence occurred at a similar interval after ALK and DALK (3.7 and 3.2 years, respectively). Significant recurrence-free survival was longer for PKP than for ALK, DALK, or PTK (P = 0.04). The time required to obtain BCVA was shorter in the PTK group (median 1.8 months) than in the PKP and DALK groups (median 5.3 and 8.4 months, respectively; P = 0.03 and P = 0.02). All groups achieved a similar median BCVA (20/25-20/30). This series indicates that GCD1 recurrence-free survival is longest after PKP with an associated delay in attaining BCVA. Conversely, PTK provided the fastest visual recovery with shorter recurrence-free survival.