eMedicine Specialties > Ophthalmology > Cornea

Dystrophy, Lattice: Treatment & Medication

Author: William Trattler, MD, Miami Center for Excellence in Eye Care; Consulting Staff, Department of Ophthalmology, Miami Baptist Hospital
Coauthor(s): William Lloyd Clark, MD, Consulting Staff, Palmetto Retina; Natalie Afshari, MD, Assistant Professor, Cornea and Refractive Surgery, Department of Ophthalmology, Duke University Eye Center, Duke University Medical Center
Contributor Information and Disclosures

Updated: Mar 15, 2006

Treatment

Medical Care

When recurrent erosions occur with this condition, they are treated similar to any other form of recurrent erosion. Under the care of an ophthalmologist, a bandage contact lens along with antibiotics can be prescribed. Alternatively, patching with an antibiotic ointment can be used. Once the acute episode of recurrent erosion has resolved, preventative treatments may include Muro 128 drops, lubrication drops, and lubricating ointment at bedtime. If recurrent corneal erosions occur despite medical therapy, then excimer laser treatment (PTK) may be considered.

Surgical Care

Excessive corneal erosions or mild visual decreases can be treated with PTK. The excimer laser removes the opacities, smooths the corneal surface, and allows the epithelium to re-adhere more tightly. If the visual acuity drops and the opacities are deep, a lamellar or full-thickness corneal transplant can be performed. Although the success rate for a corneal transplant is very high, lattice deposits can recur.

Medication

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

Hypertonic saline

Dehydrates epithelium, allowing epithelium to adhere better to underlying stroma.


Sodium chloride 5% (Muro 128)

For osmotic pressure control and water distribution. Dehydrates epithelium, allowing epithelium to adhere better to underlying stroma.

Adult

Solution: 1-2 gtt into affected eye q3-4h

Pediatric

Not established

Pregnancy

A - Safe in pregnancy

Precautions

Caution in edema and sodium toxicity

Lubricating drops

Can moisten ocular surface, and decrease number of recurrent erosion episodes.


Artificial tears (GenTeal, Refresh, Bion tears)

Can moisten ocular surface and decrease number of recurrent erosion episodes.

Adult

1 gtt to affected eye 4-6 times/d

Pediatric

Administer as in adults

Pregnancy

A - Safe in pregnancy

Precautions

Hyperemia, photophobia, stickiness of eyelashes, and ocular discomfort or irritation may occur

More on Dystrophy, Lattice

Overview: Dystrophy, Lattice
Differential Diagnoses & Workup: Dystrophy, Lattice
Treatment & Medication: Dystrophy, Lattice
Follow-up: Dystrophy, Lattice
Multimedia: Dystrophy, Lattice
References
[ CLOSE WINDOW ]

References

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

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

  3. Das S, Langenbucher A, Seitz B. Delayed healing of corneal epithelium after phototherapeutic keratectomy for lattice dystrophy. Cornea. Apr 2005;24(3):283-7. [Medline].

  4. Kawashima M, Yamada M, Funayama T, et al. Six cases of late-onset lattice corneal dystrophy associated with gene mutations induced by the transforming growth factor-beta. Nippon Ganka Gakkai Zasshi. Feb 2005;109(2):93-100. [Medline].

  5. Krachmer J. Cornea (3 volume set). Vol 2. 1996.

  6. Mashima Y, Yamamoto S, Inoue Y, et al. Association of autosomal dominantly inherited corneal dystrophies with BIGH3 gene mutations in Japan. Am J Ophthalmol. Oct 2000;130(4):516-7. [Medline].

  7. Stone EM, Mathers WD, Rosenwasser GO, et al. Three autosomal dominant corneal dystrophies map to chromosome 5q. Nat Genet. 1994;6(1):47-51. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

lattice dystrophy, corneal dystrophy, stromal dystrophy, stromal dystrophies, corneal erosion, corneal transplant, phototherapeutic keratectomy, PTK

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

William Trattler, MD, Miami Center for Excellence in Eye Care; Consulting Staff, Department of Ophthalmology, Miami Baptist Hospital
William Trattler, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

William Lloyd Clark, MD, Consulting Staff, Palmetto Retina
William Lloyd Clark, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Natalie Afshari, MD, Assistant Professor, Cornea and Refractive Surgery, Department of Ophthalmology, Duke University Eye Center, Duke University Medical Center
Disclosure: Nothing to disclose.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

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, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.