Exacerbation of Avellino Corneal Dystrophy After Laser In Situ Keratomileusis

Abstract

LASIK is contraindicated in patients with Avellino corneal dystrophy because vision may be reduced by corneal opacities that appear in the interface of the flap and remaining posterior stroma postoperatively.

Avellino Corneal Dystrophy Exacerbated After LASIK

“…DNA analysis, performed in all 3 patients as previously described, 6 showed them to be heterozygous for the ACD gene. Preoperative characteristics of each and details of the surgeries are shown in Table 1.…”

“…4,5 In patients with heterozygous ACD, the corneal deposits increase after laser in situ keratomileusis (LASIK). 6 From the reported cases so far, the opaque corneal deposits after LASIK were observed along the interface between the flap and residual stroma. The removed deposits turned out to be hyaline, which is a component of the granules in ACD.…”

“…The removed deposits turned out to be hyaline, which is a component of the granules in ACD. 6 Additional trauma, such as lifting the flap and mechanically removing the opaque materials from the surfaces of flap and the posterior remaining stroma, is known to increase the delayed development of the deposits. 7 Even though all ACD patients show R124H mutation in the Aig-h3 gene, which is activated by TGF-A, the pathogenesis of the ACD is not known yet.…”

Excimer laser exacerbation of Avellino corneal dystrophy

“…[1][2][3][4][5][6] This relatively rare autosomal dominant corneal dystrophy was first reported in 1988 in individuals from Avellino, Italy 7 ; however, it is now found worldwide. 8,9 Avellino corneal dystrophy is characterized by hyaline and amyloid corneal stromal deposits, features of granular corneal dystrophy and lattice corneal dystrophy, respectively.…”

“…[1][2][3][4][5][6] We report a case of heterozygous Avellino corneal dystrophy exacerbated by LASIK in a white North American; penetrating keratoplasty (PKP) was eventually required. Diagnostic confirmation was obtained with corneal histopathology, electron microscopy, and genetic DNA analysis.…”