Femtosecond Laser–Assisted Lamellar Keratectomy for Corneal Opacities Secondary to Anterior Corneal Dystrophies

Bernhard Steger, Vito Romano, Simon Biddolph, Colin Willoughby, Mark Batterbury, Stephen B. Kaye

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    PURPOSE:To report results of femtosecond laser-assisted lamellar keratectomy (FLK) for corneal opacities secondary to anterior corneal dystrophies.METHODS:Patients with a clinical diagnosis of Reis-Bücklers corneal dystrophy, granular corneal dystrophy, lattice corneal dystrophy, and macular corneal dystrophy were treated. FLK was performed to remove a central corneal free cap of 9.5 mm in diameter at a depth of 110 to 140 μm on which histological analysis was undertaken. Preoperative and postoperative refraction, best spectacle-corrected visual acuity, corneal topography results, and color photographs were recorded. Postoperative in vivo confocal microscopy of the cornea was performed. Changes in uncorrected visual acuity and best spectacle-corrected visual acuity, keratometry, refractive error, corneal irregularity, residual or recurrent central corneal opacities, and corneal haze were used to assess the outcome.RESULTS:Eight eyes of 6 patients were treated. The clinical diagnosis was confirmed histologically in all cases. Visual acuity improved significantly from 0.49 ± 0.2 logMAR to 0.14 ± 0.13 logMAR after a mean follow-up of 29 ± 14 (range 8-54) months. Residual central stromal opacities were noted in 5 of 8 eyes immediately postoperatively. Clinically significant recurrence of disease was noted in 1 eye. Keratometry and refraction remained stable, and no further surgical intervention was needed. Patients with stromal corneal dystrophies had worse outcome than those with Reis-Bücklers corneal dystrophy.CONCLUSIONS:In this case series, FLK provided both therapeutic and diagnostic intervention, delaying more invasive surgery. In vivo confocal microscopy showed signs of postoperative corneal stromal neuropathy.
    LanguageEnglish
    Pages6-13
    JournalCORNEA
    Volume35
    Issue number1
    DOIs
    Publication statusAccepted/In press - 13 Sep 2015

    Fingerprint

    Corneal Opacity
    Visual Acuity
    Lasers
    Confocal Microscopy
    Hereditary Corneal Dystrophies
    Corneal Topography
    Refractive Errors
    Cornea
    Color
    Recurrence
    Intravital Microscopy
    Corneal dystrophy of Bowman layer, type 1

    Keywords

    • cornea
    • corneal dystrophy
    • femtosecond laser

    Cite this

    Steger, Bernhard ; Romano, Vito ; Biddolph, Simon ; Willoughby, Colin ; Batterbury, Mark ; Kaye, Stephen B. / Femtosecond Laser–Assisted Lamellar Keratectomy for Corneal Opacities Secondary to Anterior Corneal Dystrophies. In: CORNEA. 2015 ; Vol. 35, No. 1. pp. 6-13.
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    abstract = "PURPOSE:To report results of femtosecond laser-assisted lamellar keratectomy (FLK) for corneal opacities secondary to anterior corneal dystrophies.METHODS:Patients with a clinical diagnosis of Reis-B{\"u}cklers corneal dystrophy, granular corneal dystrophy, lattice corneal dystrophy, and macular corneal dystrophy were treated. FLK was performed to remove a central corneal free cap of 9.5 mm in diameter at a depth of 110 to 140 μm on which histological analysis was undertaken. Preoperative and postoperative refraction, best spectacle-corrected visual acuity, corneal topography results, and color photographs were recorded. Postoperative in vivo confocal microscopy of the cornea was performed. Changes in uncorrected visual acuity and best spectacle-corrected visual acuity, keratometry, refractive error, corneal irregularity, residual or recurrent central corneal opacities, and corneal haze were used to assess the outcome.RESULTS:Eight eyes of 6 patients were treated. The clinical diagnosis was confirmed histologically in all cases. Visual acuity improved significantly from 0.49 ± 0.2 logMAR to 0.14 ± 0.13 logMAR after a mean follow-up of 29 ± 14 (range 8-54) months. Residual central stromal opacities were noted in 5 of 8 eyes immediately postoperatively. Clinically significant recurrence of disease was noted in 1 eye. Keratometry and refraction remained stable, and no further surgical intervention was needed. Patients with stromal corneal dystrophies had worse outcome than those with Reis-B{\"u}cklers corneal dystrophy.CONCLUSIONS:In this case series, FLK provided both therapeutic and diagnostic intervention, delaying more invasive surgery. In vivo confocal microscopy showed signs of postoperative corneal stromal neuropathy.",
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    Femtosecond Laser–Assisted Lamellar Keratectomy for Corneal Opacities Secondary to Anterior Corneal Dystrophies. / Steger, Bernhard; Romano, Vito; Biddolph, Simon; Willoughby, Colin; Batterbury, Mark; Kaye, Stephen B.

    In: CORNEA, Vol. 35, No. 1, 13.09.2015, p. 6-13.

    Research output: Contribution to journalArticle

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    T1 - Femtosecond Laser–Assisted Lamellar Keratectomy for Corneal Opacities Secondary to Anterior Corneal Dystrophies

    AU - Steger, Bernhard

    AU - Romano, Vito

    AU - Biddolph, Simon

    AU - Willoughby, Colin

    AU - Batterbury, Mark

    AU - Kaye, Stephen B.

    PY - 2015/9/13

    Y1 - 2015/9/13

    N2 - PURPOSE:To report results of femtosecond laser-assisted lamellar keratectomy (FLK) for corneal opacities secondary to anterior corneal dystrophies.METHODS:Patients with a clinical diagnosis of Reis-Bücklers corneal dystrophy, granular corneal dystrophy, lattice corneal dystrophy, and macular corneal dystrophy were treated. FLK was performed to remove a central corneal free cap of 9.5 mm in diameter at a depth of 110 to 140 μm on which histological analysis was undertaken. Preoperative and postoperative refraction, best spectacle-corrected visual acuity, corneal topography results, and color photographs were recorded. Postoperative in vivo confocal microscopy of the cornea was performed. Changes in uncorrected visual acuity and best spectacle-corrected visual acuity, keratometry, refractive error, corneal irregularity, residual or recurrent central corneal opacities, and corneal haze were used to assess the outcome.RESULTS:Eight eyes of 6 patients were treated. The clinical diagnosis was confirmed histologically in all cases. Visual acuity improved significantly from 0.49 ± 0.2 logMAR to 0.14 ± 0.13 logMAR after a mean follow-up of 29 ± 14 (range 8-54) months. Residual central stromal opacities were noted in 5 of 8 eyes immediately postoperatively. Clinically significant recurrence of disease was noted in 1 eye. Keratometry and refraction remained stable, and no further surgical intervention was needed. Patients with stromal corneal dystrophies had worse outcome than those with Reis-Bücklers corneal dystrophy.CONCLUSIONS:In this case series, FLK provided both therapeutic and diagnostic intervention, delaying more invasive surgery. In vivo confocal microscopy showed signs of postoperative corneal stromal neuropathy.

    AB - PURPOSE:To report results of femtosecond laser-assisted lamellar keratectomy (FLK) for corneal opacities secondary to anterior corneal dystrophies.METHODS:Patients with a clinical diagnosis of Reis-Bücklers corneal dystrophy, granular corneal dystrophy, lattice corneal dystrophy, and macular corneal dystrophy were treated. FLK was performed to remove a central corneal free cap of 9.5 mm in diameter at a depth of 110 to 140 μm on which histological analysis was undertaken. Preoperative and postoperative refraction, best spectacle-corrected visual acuity, corneal topography results, and color photographs were recorded. Postoperative in vivo confocal microscopy of the cornea was performed. Changes in uncorrected visual acuity and best spectacle-corrected visual acuity, keratometry, refractive error, corneal irregularity, residual or recurrent central corneal opacities, and corneal haze were used to assess the outcome.RESULTS:Eight eyes of 6 patients were treated. The clinical diagnosis was confirmed histologically in all cases. Visual acuity improved significantly from 0.49 ± 0.2 logMAR to 0.14 ± 0.13 logMAR after a mean follow-up of 29 ± 14 (range 8-54) months. Residual central stromal opacities were noted in 5 of 8 eyes immediately postoperatively. Clinically significant recurrence of disease was noted in 1 eye. Keratometry and refraction remained stable, and no further surgical intervention was needed. Patients with stromal corneal dystrophies had worse outcome than those with Reis-Bücklers corneal dystrophy.CONCLUSIONS:In this case series, FLK provided both therapeutic and diagnostic intervention, delaying more invasive surgery. In vivo confocal microscopy showed signs of postoperative corneal stromal neuropathy.

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    KW - corneal dystrophy

    KW - femtosecond laser

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