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CASE REPORT

Combined Topography-Guided Trans-Epithelial PRK and PTK for Recalcitrant Recurrent Corneal Erosions in Lattice Corneal Dystrophy

ORCID Icon, , , ORCID Icon &
Pages 275-280 | Received 27 Jan 2023, Accepted 18 Apr 2023, Published online: 10 May 2023
 

Abstract

Purpose

To report morphologic and functional changes after topography-guided trans-epithelial photorefractive keratectomy (PRK) combined with phototherapeutic keratectomy (PTK) for recalcitrant recurrent corneal erosions in Lattice Corneal Dystrophy (LCD).

Methods

One case report.

Results

A 78-year-old man presented us with decreased visual acuity [20/100 in right eye (RE), and 20/400 in left eye (LE)], and redness with foreign body sensation in both eyes. Clinical examination revealed epithelial erosions, and linear stromal opacities involving the center of the cornea in both eyes, supporting the diagnosis of LCD. Several medical approaches including autologous serum, amniotic membrane extract, and nerve growth factor eye drops allowed a temporary improvement in symptoms. A single-step topography-guided trans-epithelial PRK combined with PTK (CIPTA®2 software, iVis Technologies) was performed in both eyes. After surface ablation using PRK, PTK was performed using masking agents (1% hydroxy-methylcellulose) to smooth the ablated surface. Subsequently, 0.02% Mitomycin C was applied over the ablated surface. At the 3-month follow-up, a resolution of corneal erosions, and stromal opacities were observed in both eyes, with a visual improvement to 20/25 in the RE and 20/50 in the LE. Furthermore, spherical equivalent, keratometric astigmatism, and corneal morphological irregularity index improved.

Conclusion

Recalcitrant corneal erosions and stromal opacities in LCD may be successfully treated using combined topography-guided trans-epithelial PRK and PTK.

Disclosure

There are no conflicts of interest.

Additional information

Funding

There is no funding to report.