Corneal electrolysis for recurrence of corneal stromal dystrophy after keratoplasty.
OBJECTIVE
To evaluate corneal electrolysis as a treatment for recurrent diffuse corneal opacities at the host-graft interface of the stroma or at the subepithelial region in two types of granular corneal dystrophy (GCD).


METHODS
Recurrence developed at the host-graft interface of the stroma after lamellar keratoplasty in a patient with Avellino corneal dystrophy (ACD). At surgery, the deep aspect of the graft in this patient was partially separated from host tissue to expose the deposits, with one third of the host-graft junction left intact. The graft was everted, and electrolysis was applied directly to remove the deposits attached to both surfaces of the host and the graft. Then the graft was returned to its place and sutured. In two patients with homozygous ACD and one patient with the superficial variant of GCD, diffuse subepithelial opacities developed following penetrating keratoplasty. Electrolysis was applied directly to the corneal surface.


RESULTS
Deposits at the host-graft interface of the stroma and in the subepithelial region disappeared following treatment, and vision recovered in all patients.


CONCLUSIONS
This method is a simple, easy, and inexpensive way to remove deposits that recur after lamellar or penetrating keratoplasty.
Mashima
Y
Y
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. mashima@sc.itc.keio.ac.jp
Kawai
M
M
Yamada
M
M
D000368:Aged; D003317:Corneal Dystrophies, Hereditary / Q000503:physiopathology / Q000601:surgery*; D003318:Corneal Opacity / Q000503:physiopathology / Q000628:therapy*; D016039:Corneal Transplantation / Q000379:methods*; D004572:Electrolysis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology