Unusual early recurrence of granular dystrophy after deep anterior lamellar keratoplasty: case report

Rama, Paolo; Knutsson, Karl Anders; Rojo, Carmen; Carrera, Paola; Ferrari, Maurizio

doi:10.1590/s0004-27492013000200015

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…To our knowledge, there is only 1 published case of deep stromal deposits in a recurrence after deep anterior lamellar keratoplasty. 24 Moreover, it may be observed that in this case a thin stromal lamella remained during preparation of the deep anterior lamella and that this remaining stroma may have contributed to the recurrence and not invading keratocytes from the border of the graft. A limitation of the presented cases is our inability to provide full evidence for the survival of the donor limbal stem cells due to the patients’ refusal to undergo a biopsy of the graft.…”

Section: Discussionmentioning

confidence: 76%

Simultaneous Transplantation of Limbal Stem Cells May Reduce Recurrences of Granular Dystrophy After Corneal Transplantation

et al. 2015

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To present 2 cases with long-term relapse-free intervals only after limbo-keratoplasty but not after conventional penetrating keratoplasty in granular dystrophy.Retrospective review of the patient charts and photographs taken during long-term follow-up of 2 cases with granular dystrophy, in which 1 eye received penetrating keratoplasty and the fellow eye received penetrating limbo-keratoplasty.In the first patient, 1 eye showed extensive recurrence of granular deposits 17 years after penetrating keratoplasty was performed while in the second eye two-thirds of the corneal transplant adjacent to the transplanted limbal area remained clear 12 years after the limbo-corneal transplant. In the second patient, 1 eye showed no signs of recurrence 5 years after limbo-keratoplasty, whereas a recurrence of granular corneal deposits occurred 18 months after surgery in the fellow eye.These cases show that the simultaneous transplantation of healthy donor limbus when performing penetrating keratoplasty may prolong recurrence in granular corneal dystrophy. Although we were unable to prove it on the molecular level, these clinical courses may support the hypothesis that a limbal transplant helps prevent a recurrence.

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Section: Discussionmentioning

confidence: 76%

Simultaneous Transplantation of Limbal Stem Cells May Reduce Recurrences of Granular Dystrophy After Corneal Transplantation

et al. 2015

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“…Some suggest that GCD has an epithelial origin and may recur anteriorly [ 31 , 58 ]. This hypothesis has not been confirmed, though, as contradictory papers suggest otherwise, i.e., the role of residual keratocytes and the type of mutation have a role in the pattern of recurrence [ 57 , 71 , 72 ]. Pantanelli et al reported a case of GCD with a recurrence of the disease 3 years following an 8 mm DALK.…”

Section: Granular Dystrophymentioning

confidence: 99%

Management of Stromal Corneal Dystrophies; Review of the Literature with a Focus on Phototherapeutic Keratectomy and Keratoplasty

Ashena

Niestrata

Tavassoli

2023

Vision

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Corneal dystrophies are a group of non-inflammatory inherited disorders of the cornea. This review considers treatment options for epithelial-stromal and stromal corneal dystrophies: namely Reis–Bücklers, Thiel–Behnke, lattice, Avellino, granular, macular and Schnyder corneal dystrophies. Where there is visual reduction, treatment options may include either phototherapeutic keratectomy (PTK) or corneal transplantation. Due to the anterior location of the deposits in Reis-Bücklers and Thiel–Behnke dystrophies, PTK is considered the treatment of choice. For lattice, Avellino, granular and macular corneal dystrophies, PTK provides temporary visual improvement; however, with recurrences, repeat PTK or a corneal transplant would be needed. For Schnyder dystrophy, should treatment be required, PTK may be the preferred option due to the potential for recurrence of the disease in corneal transplantation. This review discusses the literature and evidence base for the treatment of corneal dystrophies in terms of visual outcomes and recurrence rate.

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Granular corneal dystrophy recurrence at the posterior graft-host interface after type 1 big bubble deep anterior lamellar keratoplasty

Oke

Haddad

Lee

2020

American Journal of Ophthalmology Case Reports

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Purpose To describe our observations of granular corneal dystrophy (GCD) recurrence isolated to the posterior graft-host interface after type 1 big bubble (BB) deep anterior lamellar keratoplasty (DALK). Observations We performed a retrospective chart review of 3 eyes in 2 patients, and literature review to summarize GCD recurrence patterns after DALK. A 29-year-old man with GCD underwent DALK by type 1 BB technique. Three years following surgery, he was found to have recurrence of GCD deposits isolated to the posterior graft-host interface. Similarly, a 53-year-old woman with GCD underwent DALK by BB type 1 technique, and was noted to have trace residual deposits at the posterior graft-host interface that increased in number and size over the course of 6 years. Her fellow eye underwent DALK with type 2 BB formation, without evidence of graft-host interface recurrence over a four year period. Our literature review describes the recurrence patterns of 18 cases of GCD following DALK. Conclusions and importance DALK can be prone to GCD recurrence in the central posterior graft-host interface. Recurrent deposits isolated to the posterior graft-host interface following type 1 BB DALK supports the hypothesis that GCD recurrence may be due to residual pathologic keratocytes in the pre-Descemet layer (PDL).

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Unusual early recurrence of granular dystrophy after deep anterior lamellar keratoplasty: case report

Cited by 4 publications

References 7 publications

Simultaneous Transplantation of Limbal Stem Cells May Reduce Recurrences of Granular Dystrophy After Corneal Transplantation

Simultaneous Transplantation of Limbal Stem Cells May Reduce Recurrences of Granular Dystrophy After Corneal Transplantation

Management of Stromal Corneal Dystrophies; Review of the Literature with a Focus on Phototherapeutic Keratectomy and Keratoplasty

Granular corneal dystrophy recurrence at the posterior graft-host interface after type 1 big bubble deep anterior lamellar keratoplasty

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