Journal of the Korean Ophthalmological Society 2003;44(11):2465-2472.
Published online November 1, 2003.
Phototherapeutic Keratectomy for Granular Corneal Dystrophy.
Joo Wan Park, Jae Ho Kim
1Department of Ophthalmology, Kangnam St.Mary's Hospital, The Catholic University of Korea, College of Medicine, Korea.
2Department of Ophthalmology, Seoul Paik Hospital, Inje University, College of Medicine, Korea. kimjheye@ijnc.inje.ac.kr
과립각막이상증의 치료레이저각막절제술 효과
박주완 ( Park Ju Wan ) , 김재호 ( Kim Jae Ho )
Abstract
PURPOSE
In this study, we evaluated the results of PTK(phototherapeutic keratectomy) for granular corneal dystrophy. METHODS: 5 eyes (4 patients) with granular corneal dystrophy were treated by PTK using Summit ExiMed UV200 and VSIX Star excimer laser systems. The epithelium was removed mechanically with a surgical blade. We used methylcellulose 1.0% as a surface modulator before laser ablation. Focal ablations of the central cornea with an ablation zone of 6.0 mm were performed. Mean ablation depth was 105 +/- 15.81 micrometer (range; 80~120 micrometer) Additional hyperopic PRK was performed on 4 eyes out of 5 eyes at the corneal mid-periphery up to maximum +5.00 D to prevent post-PTK hyperopic shift. Mean follow up period was 54.4 +/- 23.43months (range; 24~84months). RESULTS: Removal of corneal opacities allowed for improvement in both uncorrected visual acuity and best corrected visual acuity in all patients. There was an improvement in best-corrected visual acuity of a mean of 2.6 lines on the Snellen chart. Mean corneal thickness in the area of pathology decreased from 490.5 micrometer before surgery to 391.5 micrometer after surgery. There was a hyperopic shift in all the eyes in spite of additional hyperopic PRK by a mean of +2.44 +/- 0.99 D. There was mild recurrent dystrophic change in an eye but not significant enough to affect visual acuity during the follow up period. No major complications developed in any patients. CONCLUSIONS: Our results suggest that PTK is a safe and effective alternative to penetrating and lamellar keratoplasty in patients with granular corneal dystrophy. Mild post-PTK hyperopic shift occurred in all patients in spite of combined hyperopic PRK up to maximum +5.00 D correction at the corneal mid- peripheral zone according to the refractive powers.
Key Words: Granular corneal dystrophy;Hyperopic PRK;PTK (Phototherapeutic keratectomy)


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