Biomaterial Database

[Phototherapeutic keratectomy in recurrences of granular corneal dystrophy after keratoplasty]. 1995

P Heinz, and W Wiegand, and P Kroll

Medizinisches Zentrum für Augenheilkunde, Philipps-Universität Marburg.

BACKGROUND Recurrences of granular corneal dystrophy (Groenouw type I dystrophy) after penetrating keratoplasty have been often reported in the literature. Up to now the therapy of these recurrences consists in performing a lamellar or penetrating re-keratoplasty. As those recurrent opacities at first are located in the area of Bowman's membrane and the superficial corneal stroma, a phototherapeutic keratectomy (PTK) with an excimer laser offers a therapeutic alternative to re-keratoplasty. METHODS We describe three eyes of two patients with recurrent opacities on the transplant after successful keratoplasty because of granular corneal dystrophy. In all eyes we performed an excimer-laser PTK (Keratom of Schwind Company, Kleinostheim/Germany, wave length 193 nm) after abrasion of the epithelium with a hockey-knife. The depth of ablation depended on the location of the opacities and was between 7 microns and 35 microns. During the excimer-laser treatment several biomicroscopical slit-lamp controls were performed to make sure whether a sufficient depth of ablation was obtained. RESULTS The opacities could be totally removed in all eyes by excimer-laser PTK. Postoperatively the visual acuity increased and the patient's photophobia decreased. At the same time a slight progression of hyperopia developed depending on the depth of ablation. During the follow-up period of 5 to 12 months no recurrent opacities could be found until now. CONCLUSIONS Phototherapeutic keratectomy with the excimer laser seems to be a good alternative to re-keratoplasty in superficially located recurrences of granular corneal dystrophy in a graft after keratoplasty. A slight progression of hyperopia depending on the depth of ablation has to be accepted. The future will show whether there will develops recurrent opacities of the dystrophy after an excimer laser treatment.

UI	MeSH Term	Description	Entries
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010789	Phototherapy	Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths.	Blue Light Therapy,Blue-light Therapy,Light Therapy,Photoradiation Therapy,Red Light Phototherapy,Therapy, Photoradiation,Blue Light Therapies,Blue-light Therapies,Light Phototherapies, Red,Light Phototherapy, Red,Light Therapies,Light Therapies, Blue,Light Therapy, Blue,Photoradiation Therapies,Phototherapies,Phototherapies, Red Light,Phototherapy, Red Light,Red Light Phototherapies,Therapies, Blue Light,Therapies, Blue-light,Therapies, Light,Therapies, Photoradiation,Therapy, Blue Light,Therapy, Blue-light,Therapy, Light
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012008	Recurrence	The return of a sign, symptom, or disease after a remission.	Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D003315	Cornea	The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed)	Corneas
D003317	Corneal Dystrophies, Hereditary	Bilateral hereditary disorders of the cornea, usually autosomal dominant, which may be present at birth but more frequently develop during adolescence and progress slowly throughout life. Central macular dystrophy is transmitted as an autosomal recessive defect.	Corneal Dystrophies,Granular Dystrophy, Corneal,Groenouw's Dystrophies,Macular Dystrophy, Corneal,Stromal Dystrophies, Corneal,Corneal Dystrophy,Corneal Dystrophy, Hereditary,Corneal Granular Dystrophies,Corneal Granular Dystrophy,Corneal Macular Dystrophies,Corneal Macular Dystrophy,Corneal Stromal Dystrophies,Corneal Stromal Dystrophy,Dystrophy, Corneal,Dystrophy, Corneal Granular,Dystrophy, Corneal Macular,Dystrophy, Corneal Stromal,Dystrophy, Hereditary Corneal,Groenouw Dystrophies,Groenouws Dystrophies,Hereditary Corneal Dystrophies,Hereditary Corneal Dystrophy,Stromal Dystrophy, Corneal
D003318	Corneal Opacity	Disorder occurring in the central or peripheral area of the cornea. The usual degree of transparency becomes relatively opaque.	Leukoma,Corneal Opacities,Leukomas,Opacities, Corneal,Opacity, Corneal
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D015948	Keratoplasty, Penetrating	Partial or total replacement of all layers of a central portion of the cornea.	Keratoplasties, Penetrating,Penetrating Keratoplasties,Penetrating Keratoplasty