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Phototherapeutic Keratectomy in Diffuse Stromal Haze in Granular Corneal Dystrophy Type 2

 Jung, Se Hwan  ;  Han, Kyung Eun  ;  Stulting, R. Doyle  ;  Sgrignoli, Bradford  ;  Kim, Tae-im  ;  Kim, Eung Kweon 
 CORNEA, Vol.32(3) : 296-300, 2013 
Journal Title
Issue Date
Adult ; Aged ; Corneal Dystrophies, Hereditary/diagnosis ; Corneal Dystrophies, Hereditary/physiopathology ; Corneal Dystrophies, Hereditary/surgery* ; Corneal Stroma/pathology ; Corneal Stroma/surgery* ; Female ; Follow-Up Studies ; Fourier Analysis ; Humans ; Lasers, Excimer/therapeutic use* ; Male ; Middle Aged ; Photorefractive Keratectomy* ; Tomography, Optical Coherence ; Visual Acuity/physiology
granular corneal dystrophy type 2 ; Avellino corneal dystrophy ; diffuse haze ; phototherapeutic keratectomy ; Fourier domain optical coherence tomography
Purpose: To determine the minimum depth of phototherapeutic keratectomy (PTK) required for diffuse haze removal in granular corneal dystrophy type 2 and to determine whether Fourier domain optical coherence tomography (FD-OCT) can be an effective technique for predicting the exact required depth of ablation. Methods: The depth of ablation used for diffuse stromal haze removal was evaluated with the slit lamp and serially taken photographs during the PTK procedure. The depth of diffuse haze was measured preoperatively using FD-OCT. Results: Forty-three eyes of 30 patients were included in this study. The mean age of the patients was 62.0 ± 8.4 years. The mean depth of PTK required was 43.7 ± 6.2 μm (range, 31–59 μm). The mean follow-up period for 29 eyes of 22 patients, who had follow-up periods of more than 6 months, was 21.0 ± 12.0 months. The mean best spectacle-corrected visual acuity of these 29 eyes was 0.43 ± 0.15 preoperatively and 0.71 ± 0.16 (P = 0.022) 1 month postoperatively. Of the 43 eyes of 30 patients, FD-OCT was evaluated in 29 eyes of 22 patients. The mean preoperative depth of diffuse haze using FD-OCT was 44.3 ± 6.4 μm. The mean depth of ablation required to remove diffuse stromal haze was 44.5 ± 5.9 μm. The actual ablated depths correlated well with the depth of haze detected by FD-OCT preoperatively (intraclass correlation coefficient = 0.719). Conclusions: FD-OCT is an accurate method of predicting the depth of PTK required to remove visually significant diffuse haze in patients with granular corneal dystrophy type 2. We advocate the use of slit-lamp biomicroscopy after the initial 30-μm ablation to determine the necessity for any further ablation.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Kim, Tae Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Jung, Se Hwan(정세환)
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