Phototherapeutic keratectomy for BIGH3-linked corneal dystrophy recurring after penetrating keratoplasty.
OBJECTIVE
To determine visual results and report side effects and complications after phototherapeutic keratectomy (PTK) for BIGH3-linked corneal dystrophy recurring after penetrating keratoplasty.


METHODS
Retrospective noncomparative case series.


METHODS
Forty-two excimer laser PTK procedures were performed in 42 eyes of 29 patients with BIGH3-linked corneal dystrophies. Genetic status of all patients was determined and allowed us to assess an unambiguous diagnosis. Preoperative diagnoses included LCDIIIA/A546T (1 eye), R124 l+DT125-DE126 (4 eyes), GICD/R555W (14 eyes), LCDI/R124C (6 eyes), SGD/R124 l (16 eyes), and CDBII/R555Q (1 eye).


METHODS
Two excimer lasers (Summit Excimed UV 200, Summit Technology, Waltham, MA and Nidek EC 5000, Nidek, Inc., Gamagori, Japan) were used to perform all PTKs. Indications for performing PTK after a graft were severe decrease of the best-corrected visual acuity (BCVA) related to recurrent corneal deposits and/or painful recurrent epithelial erosions.


METHODS
Preoperative and postoperative BCVA were analyzed, significant recurrences after treatment were noted, and postoperative complications were recorded.


RESULTS
Mean preoperative BCVA was 0.2 +/- 0.12 in the decimal chart, mean postoperative BCVA was 0.52 +/- 0.16 with a mean follow-up of 3.13 +/- 1.77 years (range, 0.3-6.65 years). Visual acuity was significantly improved after surgery (P < 0.05). The magnitude of the change in visual acuity was dependent on the mutation (P < 0.001). Seven symptomatic recurrences were observed. One regressive graft rejection and 4 cases of severe postoperative haze were observed. No other complications were noted.


CONCLUSIONS
PTK is a simple, safe, and efficient technique for the treatment of recurrent corneal dystrophies; in many cases it prevents or delays the major incumbent problems of repeated grafting.
Ellies
Pierre
P
Department of Ophthalmology, Hôpital Hôtel-Dieu de Paris, France.
Bejjani
Riad Antoine
RA
Bourges
Jean Louis
JL
Boelle
Pierre Yves
PY
Renard
Gilles
G
Dighiero
Paul
P
D000328:Adult; D000368:Aged; D003317:Corneal Dystrophies, Hereditary / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D004252:DNA Mutational Analysis; D016326:Extracellular Matrix Proteins; D005260:Female; D008040:Genetic Linkage; D006084:Graft Rejection; D006801:Humans; D015948:Keratoplasty, Penetrating; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D016212:Transforming Growth Factor beta / Q000235:genetics*; D017211:Treatment Failure; D014792:Visual Acuity; D000099222:betaIG-H3 Protein
D016326:Extracellular Matrix Proteins; D009363:Neoplasm Proteins; D016212:Transforming Growth Factor beta; D000099222:betaIG-H3 Protein