Granular Corneal Dystrophy Treatment & Management
- Author: Natalie A Afshari, MD, MA, FACS; Chief Editor: Hampton Roy, Sr, MD more...
When recurrent erosions occur with granular corneal dystrophy, they are treated like any other form of recurrent erosions. Under care of an ophthalmologist, bandage contact lens along with antibiotics can be prescribed; alternatively, patching with an antibiotic ointment can be used. Some physicians treat recurrent erosions with frequent antibiotic ointments while awake.
Once the acute episode of recurrent erosions has resolved, preventive treatment may include sodium chloride 5% drops (eg, Muro 128) or artificial tear lubricating drops during the day and lubricating ointment at bedtime. If recurrent corneal erosions occur despite medical therapy, then excimer laser phototherapeutic keratectomy (PTK) may be considered.
Excessive corneal erosions or visual decrease from superficial opacities can be treated with PTK. Excimer laser PTK removes superficial opacities, smooths the corneal surface, and allows the epithelium to re-adhere more tightly. When deep opacities are causing significant visual symptoms, corneal transplantation may be required.
If visual acuity worsens and most of the opacities are deep, lamellar or full-thickness corneal transplantation can be performed. Although the success rate for corneal transplantation is very high, granular deposits recur with time. Fortunately, when the deposits recur, they tend to be superficial, and amenable to treatment with excimer laser PTK.
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