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Granular Corneal Dystrophy Medication

  • Author: Natalie A Afshari, MD, MA, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Sep 22, 2014
 

Medication Summary

Medical therapy for recurrent corneal erosions includes hypertonic saline, which is believed to increase adherence of epithelium to the underlying stroma. Lubrication, especially at bedtime, also may help prevent further corneal erosions.

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Hypertonic saline drops

Class Summary

This agent dehydrates the epithelium, allowing it to better adhere to underlying stroma.

Sodium chloride hypertonic, ophthalmic (Adsorbonac, Afrin Saline Mist, Muro 128)

 

Used for temporary relief of corneal edema.

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Lubricating agents

Class Summary

These agents can moisten ocular surface and decrease the frequency of recurrent erosions.

Artificial tears (Celluvisc, Murine, Refresh, GenTeal, Refresh PM, Lacri-Lube)

 

Contains equivalent of 0.9% NaCl and are used to maintain ocular tonicity. Acts to stabilize and thicken precorneal tear film and prolong tear film breakup time, which occurs with dry eye states.

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Contributor Information and Disclosures
Author

Natalie A Afshari, MD, MA, FACS Stuart I Brown, MD, Chair in Ophthalmology In Memory of Donald P Shiley, Professor of Ophthalmology, Chief of Cornea and Refractive Surgery, Director of Education, Fellowship Program Director in Cornea and Refractive Surgery, Shiley Eye Center, University of California, San Diego, School of Medicine

Natalie A Afshari, MD, MA, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, Heed Ophthalmic Foundation

Disclosure: Nothing to disclose.

Coauthor(s)

William Lloyd Clark, MD Palmetto Retina

William Lloyd Clark, MD is a member of the following medical societies: Alpha Omega Alpha, Association for Research in Vision and Ophthalmology, American Academy of Ophthalmology

Disclosure: Nothing to disclose.

William B Trattler, MD Ophthalmologist, The Center for Excellence in Eye Care; Volunteer Assistant Professor of Ophthalmology, Bascom Palmer Eye Institute

William B Trattler, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery

Disclosure: Received consulting fee from Allergan for consulting; Received consulting fee from Alcon for consulting; Received consulting fee from Bausch & Lomb for consulting; Received consulting fee from Abbott Medical Optics for consulting; Received consulting fee from CXLUSA for none; Received consulting fee from LensAR for none.

Joanne W Ho University of California, San Diego, School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, International Society of Refractive Surgery, Cornea Society, Eye Bank Association of America

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cornea Society, Allergan, Bausch & Lomb, Bio-Tissue, Shire, TearScience, TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Allergan, Bausch & Lomb, Bio-Tissue, TearScience.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Fernando H Murillo-Lopez, MD Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

References
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  2. Weiss JS, Møller HU, Lisch W, Kinoshita S, Aldave AJ, Belin MW, et al. The IC3D classification of the corneal dystrophies. Cornea. 2008 Dec. 27 Suppl 2:S1-83. [Medline]. [Full Text].

  3. Choi SI, Kim BY, Dadakhujaev S, Oh JY, Kim TI, Kim JY, et al. Impaired autophagy and delayed autophagic clearance of transforming growth factor ß-induced protein (TGFBI) in granular corneal dystrophy type 2. Autophagy. 2012 Sep 20. 8(12):[Medline].

  4. Cho KJ, Mok JW, Na KS, Rho CR, Byun YS, Hwang HS, et al. TGFBI gene mutations in a Korean population with corneal dystrophy. Mol Vis. 2012. 18:2012-21. [Medline]. [Full Text].

  5. Klintworth GK. Corneal dystrophies. Orphanet J Rare Dis. 2009 Feb 23. 4:7. [Medline]. [Full Text].

  6. Mori H, Miura M, Iwasaki T, et al. Three-dimensional optical coherence tomography-guided phototherapeutic keratectomy for granular corneal dystrophy. Cornea. 2009 Sep. 28(8):944-7. [Medline].

  7. Dalton K, Schneider S, Sorbara L, Jones L. Confocal microscopy and optical coherence tomography imaging of hereditary granular dystrophy. Cont Lens Anterior Eye. 2009 Nov 27. [Medline].

  8. Ashar JN, Latha M, Vaddavalli PK. Phototherapeutic keratectomy versus alcohol epitheliectomy with mechanical debridement for superficial variant of granular dystrophy: A paired eye comparison. Cont Lens Anterior Eye. 2012 Oct. 35(5):236-9. [Medline].

  9. Jung SH, Han KE, Stulting RD, Sgrignoli B, Kim TI, Kim EK. Phototherapeutic Keratectomy in Diffuse Stromal Haze in Granular Corneal Dystrophy Type 2. Cornea. 2012 Apr 21. [Medline].

  10. Das S, Langenbucher A, Seitz B. Excimer laser phototherapeutic keratectomy for granular and lattice corneal dystrophy: a comparative study. J Refract Surg. 2005 Nov-Dec. 21(6):727-31. [Medline].

  11. Albert D, Jakobiec F. Principles and Practice of Ophthalmology. 1994. Vol 1: 26-49.

  12. Jung SH, Han KE, Sgrignoli B, Kim TI, Lee HK, Kim EK. Intraocular lens power calculations for cataract surgery after phototherapeutic keratectomy in granular corneal dystrophy type 2. J Refract Surg. 2012 Oct. 28(10):714-24. [Medline].

  13. Klintworth GK. Advances in the molecular genetics of corneal dystrophies. Am J Ophthalmol. 1999 Dec. 128(6):747-54. [Medline].

  14. Krachmer J. Cornea. Vol 2: 1996.

  15. Yamamoto S, Okada M, Tsujikawa M, et al. The spectrum of beta ig-h3 gene mutations in Japanese patients with corneal dystrophy. Cornea. 2000 May. 19(3 Suppl):S21-3. [Medline].

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Granular dystrophy. Image courtesy of James J Reidy, MD, FACS, Associate Professor of Ophthalmology, State University of New York, School of Medicine & Biomedical Sciences, Buffalo, New York.
The slit lamp parallelipid demonstrates the deposition of opacities throughout the central stroma.
 
 
 
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