J Korean Ophthalmol Soc > Volume 56(8); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(8):1170-1180.
DOI: https://doi.org/10.3341/jkos.2015.56.8.1170    Published online August 15, 2015.
Clinical Outcomes of Combined Photorefractive Keratectomy and Cataract Surgery in Patients with Granular Corneal Dystrophy.
Yung Ju Yoo, Mee Kum Kim, Won Ryang Wee
1Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. Kmk9@snu.ac.kr
2Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
과립형각막이상증에서 굴절교정각막레이저절제술과 백내장 수술 병합 시행 후 임상 결과
류영주1⋅김미금1,2⋅위원량1,2
서울대학교 의과대학 서울대학교병원 안과학교실1, 서울대학교 의과대학 서울대학교병원 의생명연구원2
Received: 21 November 2014   • Revised: 31 March 2015   • Accepted: 25 June 2015
Abstract
PURPOSE
To evaluate the efficacy of combined photorefractive keratectomy (PRK) and cataract surgery in granular corneal dystrophy (GCD) patients with corneal stromal haziness compromising vision and cataract and clinically significant lens opacity. METHODS: Medical records of 12 eyes that underwent PRK and cataract surgery between August 2009 and November 2013 in patients with GCD and cataracts were retrospectively evaluated. All PRKs were performed with the VISX S4 IR (VISX, Santa Clara, CA, USA). The double K SRK-T formula or double K Hoffer Q formula and postoperative corrected K were utilized to determine the intraocular lens power in patients with prior PRK. Postoperative best corrected visual acuity (BCVA), spherical equivalent, presence of the central island using topography analysis and recurrence of corneal opacity after combined PRK and cataract surgery were evaluated. RESULTS: In all eyes, the PRK was successful and 3 eyes showed recurrence of corneal opacities without visual impairment during a mean follow-up of 36.6 months. The mean BCVA improved with an average increase of 4.63 lines (minimum 1 line, maximum 9 lines) and no patient showed any BCVA loss. Final spherical equivalent was -0.56 diopter (D) and the corneal central island was reported in only 1 eye. The Maloney method using the double-K formula with the SRK/T formula showed the lowest absolute error of 0.33 +/- 0.25 D. CONCLUSIONS: Combined PRK and cataract surgery are effective methods for improving BCVA if patients with GCD have both visually significant diffuse corneal haze and clinically significant lens opacity.
Key Words: Avellino corneal dystrophy;Cataract;Granular corneal dystrophy;Photorefractive keratectomy


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