Avellino corneal dystrophy after LASIK.
OBJECTIVE
To report cases of Avellino corneal dystrophy (ACD) exacerbated by LASIK for myopia.


METHODS
Retrospective, noncomparative, interventional case series and review of the literature.


METHODS
Seven patients.


METHODS
Six patients with exacerbation of granular corneal deposits after LASIK were examined for TGFBI mutations by polymerase chain reaction sequencing of DNA. One previously reported patient who was heterozygous for the ACD gene was followed up for 16 months after mechanical removal of granular deposits from the interface after LASIK.


METHODS
Slit-lamp examination, visual acuity, manifest refraction, and DNA sequencing analysis.


RESULTS
All patients were heterozygous for the Avellino dystrophy gene. Corneal opacities appeared 12 months or more after LASIK. Best spectacle-corrected visual acuity decreased as the number and density of the opacities increased. One patient underwent mechanical removal of granules from the interface and had a severe recurrence within 16 months. Another patient had removal of the granules from the interface with PTK, followed by treatment with topical mitomycin C. In this patient, the cornea has remained relatively clear for 6 months.


CONCLUSIONS
Laser in situ keratomileusis increases the deposition of visually significant corneal opacities and is contraindicated in patients with ACD. Mechanical removal of the material from the interface does not prevent further visually significant deposits. Mitomycin C treatment, in conjunction with surgical removal of opacities, may be an effective treatment.
Jun
Roo Min
RM
Department of Ophthalmology, Ewha Womans University College of Medicine, Seoul, South Korea.
Tchah
Hungwon
H
Kim
Tae-im
TI
Stulting
R Doyle
RD
Jung
Seung Eun
SE
Seo
Kyoung Yul
KY
Lee
Dong Ho
DH
Kim
Eung Kweon
EK
D000328:Adult; D003317:Corneal Dystrophies, Hereditary / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D003318:Corneal Opacity / Q000209:etiology / Q000503:physiopathology; D016326:Extracellular Matrix Proteins / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D009154:Mutation; D016133:Polymerase Chain Reaction; D012029:Refraction, Ocular; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D016212:Transforming Growth Factor beta / Q000235:genetics; D014792:Visual Acuity; D000099222:betaIG-H3 Protein
D016326:Extracellular Matrix Proteins; D016212:Transforming Growth Factor beta; D000099222:betaIG-H3 Protein