Heterozygous Avellino corneal dystrophy 9 years after photorefractive keratectomy: natural or laser-induced accelerated course?
OBJECTIVE
To report a photorefractive keratectomy (PRK)-treated patient who first developed stromal opacities with a typical granular pattern 9 years after surgery, which was confirmed as heterozygous Avellino dystrophy by DNA analysis.


METHODS
A 37-year-old woman, who had undergone PRK 17 years ago, has been followed for glaucoma and corneal dystrophy. She had preoperative clear corneas in both eyes.


RESULTS
Nine years after PRK, at the age of 29 years, 2-3 small, white, anterior stromal corneal opacities were first detected in both eyes. Seventeen years postoperatively, multiple anterior stromal corneal deposits with a dot, crumb, or snowflake appearance were noted to the same degree in both eyes. The intervening cornea was relatively clear. Her DNA was heterozygous for the R124H mutation.


CONCLUSIONS
Slowly developing, mild corneal deposits occurred after PRK in this patient with heterozygote Avellino corneal dystrophy. Various clinical manifestations can occur after excimer laser refractive surgery in patients with Avellino corneal dystrophy.
Department of Ophthalmology and Visual Science, Korean Eye Tissue and Gene Bank Related to Blindness, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Shin Hae
SH
Park
JeeWon
J
Mok
Choun-Ki
CK
Joo
Man Soo
MS
Kim
D000328:Adult; D003317:Corneal Dystrophies, Hereditary / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D003318:Corneal Opacity / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D003319:Corneal Stroma / Q000473:pathology*; D004252:DNA Mutational Analysis; D016326:Extracellular Matrix Proteins / Q000235:genetics; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000009:adverse effects*; D009216:Myopia / Q000601:surgery; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D016212:Transforming Growth Factor beta / Q000235:genetics; D000099222:betaIG-H3 Protein
D016326:Extracellular Matrix Proteins; D016212:Transforming Growth Factor beta; D000099222:betaIG-H3 Protein