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Lattice Corneal Dystrophy Treatment & Management

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

Medical Care

When recurrent erosions occur with lattice corneal dystrophy, they are treated similarly to any other form of recurrent erosions. 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 erosions has resolved, preventative treatments may include Muro 128 drops, lubrication drops, and lubricating ointment at bedtime. If recurrent corneal erosions occur despite medical therapy, excimer laser phototherapeutic keratectomy (PTK) may be considered.[7, 8]

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Surgical Care

Excessive corneal erosions or mild visual decreases can be treated with laser phototherapeutic keratectomy (PTK). The excimer laser removes any opacities, smooths the corneal surface, and allows the epithelium to re-adhere more tightly. If visual acuity worsens and opacities are deep, a lamellar or full-thickness corneal transplant can be performed. Corneal transplants are usually not necessary until after age 40 years.[1] Although the success rate for a corneal transplant is very high, amyloid deposits can recur in the grafted tissue 2-14 years later.

A recent study examined the histopathological and ultrastructural correlate of delayed epithelial healing in eyes with lattice corneal dystrophy;[9] the study concluded that histopathological findings may correspond to reduced cell matrix interactions and may help explain the delayed healing.

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

  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. 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].

  4. Klintworth GK, Bao W, Afshari NA. Two mutations in the TGFBI (BIGH3) gene associated with lattice corneal dystrophy in an extensively studied family. Invest Ophthalmol Vis Sci. 2004 May. 45(5):1382-8. [Medline].

  5. Musch DC, Niziol LM, Stein JD, Kamyar RM, Sugar A. Prevalence of corneal dystrophies in the United States: estimates from claims data. Invest Ophthalmol Vis Sci. 2011 Aug. 52(9):6959-63. [Medline]. [Full Text].

  6. Meretoja J. Familial systemic paramyloidosis with lattice dystrophy of the cornea, progressive cranial neuropathy, skin changes and various internal symptoms. A previously unrecognized heritable syndrome. Ann Clin Res. 1969 Dec. 1(4):314-24. [Medline].

  7. 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].

  8. Morita Y, Chikama T, Yamada N, Morishige N, Sonoda KH, Nishida T. New mode of treatment for lattice corneal dystrophy type I: corneal epithelial debridement and fibronectin eye drops. Jpn J Ophthalmol. 2012 Jan. 56(1):26-30. [Medline].

  9. Resch MD, Schlotzer-Schrehardt U, Hofmann-Rummelt C, Kruse FE, Seitz B. Alterations of epithelial adhesion molecules and basement membrane components in lattice corneal dystrophy (LCD). Graefes Arch Clin Exp Ophthalmol. 2009 Aug. 247(8):1081-8. [Medline].

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

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

  12. 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. 2005 Feb. 109(2):93-100. [Medline].

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

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

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Lattice corneal 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.
Slit lamp image of lattice corneal 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.
 
 
 
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