title: New mode of treatment for lattice corneal dystrophy type I: corneal epithelial debridement and fibronectin eye drops.
abstract: OBJECTIVE
  The R124C mutation of the TGFBI gene gives rise to lattice corneal dystrophy type I, which is characterized by irregularity, turbulence, and opacity of the corneal epithelium. We investigated the efficacy of corneal epithelial debridement followed by application of autologous fibronectin eye drops in the treatment of patients with this mutation.
  
  
  METHODS
  Four patients (6 eyes; age range 25-57 years) treated between April 2006 and March 2008 were enrolled in the study. All patients had impaired visual acuity and recurrent corneal erosion. Corneal epithelial debridement was performed with a spatula at the pupillary zone, after which eye drops containing fibronectin purified from autologous serum were administered four times daily for 2 weeks to promote epithelial migration. Topical levofloxacin and betamethasone were also applied four times daily for 1 month.
  
  
  RESULTS
  All corneas achieved resurfacing within a few days of debridement. The best corrected visual acuity of all eyes improved from an average logMAR of 0.80 (range 1.40 logMAR-0.52 logMAR) before treatment to a logMAR of 0.10 (range 0.30 logMAR-0.046 logMAR) by 2-4 months after debridement.
  
  
  CONCLUSIONS
  Despite the limitation of this study setting, corneal epithelial debridement followed by administration of fibronectin eye drops seems to be effective in improving visual acuity in cases of lattice corneal dystrophy type I caused by the R124C mutation of the TGFBI gene. This treatment may be one option for temporarily improving visual acuity in lattice corneal dystrophy type I and thus may delay the requirement for phototherapeutic keratoplasty or keratoplasty.
authors.affiliation: Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Morita
authors.forename: Tai-Ichiro
authors.initials: T
authors.lastname: Chikama
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yamada
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Morishige
authors.forename: Koh-Hei
authors.initials: KH
authors.lastname: Sonoda
authors.forename: Teruo
authors.initials: T
authors.lastname: Nishida
mesh_terms: D000287:Administration, Topical; D000328:Adult; D003131:Combined Modality Therapy; D003317:Corneal Dystrophies, Hereditary / Q000188:drug therapy* / Q000235:genetics / Q000601:surgery*; D003646:Debridement; D019573:Epithelium, Corneal / Q000601:surgery*; D016326:Extracellular Matrix Proteins / Q000235:genetics; D005353:Fibronectins / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D017354:Point Mutation; D016212:Transforming Growth Factor beta / Q000235:genetics; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D000099222:betaIG-H3 Protein
chemical_list: D016326:Extracellular Matrix Proteins; D005353:Fibronectins; D009883:Ophthalmic Solutions; D016212:Transforming Growth Factor beta; D000099222:betaIG-H3 Protein
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