Phototherapeutic keratectomy for macular corneal dystrophy

PURPOSE: To report a case of early intervention with phototherapeutic kerat ectomy for treatment of macular corneal dystrophy. METHODS: We report a al-year-old Saudi male with early macular corneal dyst rophy, recurrent erosions, and decreased visual acuity, who underwent photo therapeutic keratectomy in the right eye and penetrating keratoplasty in th e left eye with more than 2 years of follow-up. RESULTS: Following phototherapeutic keratectomy, uncorrected visual acuity in the right eye improved from 20/80 to 20/30. Following penetrating kerato plasty in the left eye, uncorrected visual acuity deteriorated from 20/80 t o 20/120 due to irregular astigmatism; the eye was not amenable to improvem ent with spectacle correction, and the patient declined contact lens therap y. In the right eye, there has been no anterior recurrence, although some m id- to deep stromal haze, which is not visually significant, has developed. CONCLUSIONS: Early intervention for symptomatic, anterior macular corneal d ystrophy with phototherapeutic keratectomy is relatively safe and preferabl e to observation or penetrating keratoplasty.