Clinical and Optical Coherence Tomography Correlation of Recurrence Patterns After Femtosecond Laser–Assisted Anterior Lamellar Keratoplasty in Reis–Bucklers Corneal Dystrophy

Abstract

Purpose: The aim of this study was to report the clinical profile and patterns of recurrence after femtosecond laser–assisted anterior lamellar keratoplasty (FALK) in Reis–Bucklers corneal dystrophy. Methods: This is a case series of 5 eyes of 4 patients with Reis–Bucklers corneal dystrophy. Clinical images of recurrence were correlated with the high-resolution optical coherence tomography. Histopathologic examination of excised corneal samples was performed when possible. Results: The median time to recurrence was 2 (1–5) years after FALK. Of the 5 eyes, 1 eye had primary FALK, whereas 4 eyes had secondary interventions, which included previous phototherapeutic keratectomy (once in 1 eye and twice in 2 eyes), and previous penetrating keratoplasty, followed by phototherapeutic keratectomy (1 eye). Recurrence was noted at the level of the subepithelium. In addition, 1 eye showed interface deposits along with epithelial downgrowth at the graft–host bed. Conclusions: The 2 distinct patterns of recurrence noted were at the subepithelial region and the interface. The clinical patterns of recurrence favor an epithelial origin of recurrent deposits.