Alteration of the ocular surface with recurrence of granular/avellino corneal dystrophy after phototherapeutic keratectomy: Report of five cases and literature review

Purpose: To study the changes in ocular surface findings with recurrence af ter phototherapeutic keratectomy (PTK) in patients with Avellino and granul ar dystrophy, Design: Observational case series. Participants: Five eyes of five patients with recurrent granular/Avellino c orneal dystrophy after PTK seen at Kobe Kaisei Hospital were studied. Intervention: The patients underwent routine ophthalmic examinations, corne al sensitivity measurements, tear film breakup time (BUT), Schirmer test, t ear film lipid layer interferometry, and conjunctival impression cytology, Main Outcome Measures: The alterations of clinical features, tear function, and conjunctival impression cytology parameters with a recurrence after PT K were investigated. Results: The average pre-PTK corneal sensitivity and tear film breakup time were low in all five patients. Tear film lipid layer interferometry grade and conjunctival squamous metaplasia displayed higher grades before PTK, Al l of these parameters improved gradually after PTK and were maintained unti l a recurrence, which was associated with further worsening of the corneal sensitivity, tear function, and impression cytology parameters. Conclusions: Although PTK improves the ocular surface health in granular/Av ellino corneal dystrophies, recurrence of the initial dystrophy is associat ed with decline of the ocular surface health parameters, Our findings also suggest that corneal epithelium is most probably involved in the recurrence of the disease process in Avellino/granular corneal dystrophy, (C) 2001 by the American Academy of Ophthalmology.