Shinji Koichiro, Chikama Taiichiro, Maruoka Sachiko, Kiuchi Yoshiaki
Department of Ophthalmology and Visual Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Ophthalmology, Tsukazaki Hospital, Hyogo, 671-1227, Japan.
Ophthalmol Ther. 2021 Dec;10(4):1163-1169. doi: 10.1007/s40123-021-00399-2. Epub 2021 Oct 2.
Laser-assisted in situ keratomileusis (LASIK) exacerbates granular corneal dystrophy type 2. Post-LASIK granular corneal dystrophy type 2 is treated by several surgical techniques. To the best of our knowledge, no report has addressed the results of deep anterior lamellar keratoplasty in affected patients. Here, we report our experience regarding deep anterior lamellar keratoplasty treatment of patients with post-LASIK granular corneal dystrophy type 2.
We describe two Japanese women who underwent deep anterior lamellar keratoplasty to treat corneal opacities that worsened after LASIK.
One patient had a family history of corneal dystrophies. During the initial visit to our clinic, numerous fine opacities were found at the LASIK flap interface in both patients. The clinical findings were compatible with post-LASIK granular corneal dystrophy type 2. Both patients underwent deep anterior lamellar keratoplasty by one of the authors (T.C.). In both procedures, the surgeon used a visco-dissection technique and successfully removed the whole corneal stroma. Histopathological examination of the excised corneal button from each eye revealed amyloid and hyaline deposits at the LASIK flap interface. Neither patient experienced recurrent corneal opacity during the follow-up visit at 8 years (patient 1) and 6 years (patient 2).
Deep anterior lamellar keratoplasty can be used for the treatment of post-LASIK granular corneal dystrophy type 2. Removal of the entire host stroma may be important for the prevention of recurrent corneal opacity.
准分子激光原位角膜磨镶术（LASIK）会加重2型颗粒状角膜营养不良。LASIK术后的2型颗粒状角膜营养不良可通过多种手术技术进行治疗。据我们所知，尚无报告提及对受影响患者进行深板层角膜移植术的结果。在此，我们报告我们对LASIK术后2型颗粒状角膜营养不良患者进行深板层角膜移植术治疗的经验。
我们描述了两名接受深板层角膜移植术以治疗LASIK术后恶化的角膜混浊的日本女性。
一名患者有角膜营养不良家族史。在初次就诊于我们诊所时，两名患者的LASIK瓣界面均发现大量细小混浊。临床检查结果与LASIK术后2型颗粒状角膜营养不良相符。两名患者均由作者之一（T.C.）进行了深板层角膜移植术。在这两台手术中，外科医生采用了粘弹分离技术并成功切除了整个角膜基质。对每只眼睛切除的角膜植片进行组织病理学检查，结果显示LASIK瓣界面存在淀粉样和透明质沉积。在8年（患者1）和6年（患者2）的随访期间，两名患者均未出现复发性角膜混浊。
深板层角膜移植术可用于治疗LASIK术后2型颗粒状角膜营养不良。切除整个宿主基质对于预防复发性角膜混浊可能很重要。
