PHOTOTHERAPEUTIC KERATECTOMY FOR MAP-DOT-FINGERPRINT CORNEAL-DYSTROPHY

Purpose. To evaluate the excimer laser as a surgical instrument to tre at map-dot-fingerprint (MDF) dystrophies. Methods. Thirty eyes (24 pat ients) with MDF dystrophy were treated with phototherapeutic keratecto my (PTK). The treatment goal was either to improve vision (24 eyes) or to heal recurrent corneal erosions or both (10 eyes). Besides long-st anding reduction in visual acuity (17 eyes), associated symptoms were fluctuating visual acuity and clinical refraction (12 eyes) and monocu lar diplopia (eight eyes). In 14 eyes, two or three symptoms were pres ent, whereas 16 eyes only had one symptom. The mean age was 54 years ( range, 36-79 years), and there were 14 male and 10 female subjects. Me an follow-up was 30 months (range, 12-70 months). Results. In 14 of 17 eyes with long-standing reduction in visual acuity, best spectacle-co rrected Snellen visual acuity (BSCVA) improved by two lines or more. A ll eyes with fluctuating visual acuity/clinical refraction stabilized 1-3 months after PTK. Monocular diplopia or ''ghost images'' disappear ed in all eyes after treatment. In one of 10 eyes with recurrent corne al erosions, there was one recurrence during the follow-up period. All eyes healed shortly after treatment. No recurrence of corneal dystrop hic changes was seen in the ablation zone at the final follow-up (mean , 30 months). Dystrophic changes could, however, still be seen outside the treatment zone in 50% of the eyes, but were asymptomatic in all e yes. The mean refractive change was 0.34 +/- 1.05 (mean +/- SD) diopte rs. Conclusion. In this study, excimer laser photoablation was shown t o be an effective, safe, and stable choice of treatment for map-dot-fi ngerprint dystrophy. A refractive change, as hyperopic shift, can be a n adverse side effect in some individual cases.