Morphological evaluation of Schnyder's central crystalline dystrophy by confocal microscopy before and after phototherapeutic keratectomy

A 29-year-old man with Schnyder's central crystalline dystrophy was treated with phototherapeutic keratectomy (PTK) in his right eye. Ocular examinati on revealed abnormal deposits of cholesterol and lipid within the corneal s troma (appearing as crystalline spindle-shaped deposits), high myopia, phak ic anterior chamber intraocular lens implantation, and myopic macular degen eration in both eyes. Phototherapeutic keratectomy ablation to a central zo ne of 7.0 mm and a depth of 96 mum was performed with an Aesculap Meditec M EL-70 excimer laser. Confocal microscopy performed before PTK showed multip le deposits of large, brightly reflective crystalline material extending fr om the anterior to the mid stroma. The Z-scan curves revealed that the high est density of crystalline deposits was located within the first 140 mum of corneal depth. Six months after PTK, confocal microscopy showed a markedly decreased density of corneal crystalline deposits in the anterior (C) 2001 ASCRS and ESCRS.