Outcome of LASIK in Pre-Descemet’s Membrane Corneal Dystrophy

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Outcome of LASIK in Pre-Descemet’s Membrane Corneal Dystrophy Eung Kweon Kim, MD, Ph.D1; Jung Won Park, MD2; Tae-im Kim, MD, Ph.D1; Woosuk Chung, MD3; Sekyung Kim, MD 1 1 Corneal Dystrophy Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea 2Daegu Yonsei Eye Clinic, Daegu, Korea 3Siloam Eye Hospital, Seoul, Korea The authors have no financial interest in the subject matter of this poster.

Introduction Pre-Descemet’s membrane corneal dystrophy (PDMCD) Rare corneal dystrophy Numerous tiny pleomorphic opacities located in the deep stroma right before the Descemet’s membrane Several studies have documented adverse outcomes of LASIK in patients with other corneal dystrophies. The safety of LASIK in Pre-Descemet’s membrane corneal dystrophy is unknown. Roo Min Jun, MD et al. Avellino Corneal Dystrophy after LASIK Ophthalmology 2004;111:463–468

Objective We report the outcome of LASIK in a patient with pre-Descemet’s membrane corneal dystrophy.

Case Outcome measurements A 28-year-old man visited our clinic for corneal opacities in both eyes. He (patient 1; Pt1) accompanied with older sister (Pt2). Pre-Descemet’s membrane opacities were observed both in the patient and his sister. Patient (Pt1) did not received any operation on his eyes but his sister (Pt2) underwent LASIK on both eyes 2 years ago. Outcome measurements BCVA (best-corrected visual acuity) Slit-lamp examination Confocal microscopy (ConfoScan 4; Nidek Technologies, Vigonza, Italy) Fourier domain-OCT (RTVue-100, Optovue, Inc, Fremont, CA)

Result BCVA 20/20 on both eyes of Pt1 and Pt2 There was no significant difference in visual acuity, clinical feature and confocal microscopic findings between two patients. A. PDMCD of Pt1 B. PDMCD after LASIK of Pt2 ▲ Bilateral numerous small, gray-white faint opacities in posterior corneal stroma in both patients.

Slit lamp examination A. PDMCD of Pt1 B. PDMCD after LASIK of Pt2 The opacities were localized in deep stroma right before the Descemet’s membrane in both patients. Opacities extends to the limbus in both patients.

Slit lamp examination B. PDMCD after LASIK of Pt2 A. PDMCD of Pt1 ▲ The opacities became more evident in scleral scatter. No difference in severity of the opacities between two patients.

FD-OCT A. PDMCD of Pt1 B. PDMCD after LASIK of Pt2 There were no opacities around LASIK flap wound (B. red arrowheads).

Confocal Microscopy A. PDMCD of Pt1 B. PDMCD after LASIK of Pt2 Numerous polymorphic hyper-reflective, irregular deposits located in posterior stroma.

Conclusion LASIK didn’t cause significant clinical deterioration of pre-Descemet’s membrane corneal dystrophy for 2 years. Further long term observations of a greater number of patients are required to confirm these findings.