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Medication

Medication Summary

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

Class Summary

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

Sodium chloride hypertonic, ophthalmic (Muro 128)

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

Class Summary

These agents can moisten ocular surface and decrease the number of recurrent erosion episodes.

Artificial tears (GenTeal, Refresh, Bion tears)

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

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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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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Media Gallery

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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Table 1. Characteristics of the Three Major Stromal Corneal Dystrophies

Table 1. Characteristics of the Three Major Stromal Corneal Dystrophies

Feature	Granular Dystrophy	Macular Dystrophy	Lattice Dystrophy
Age of onset	First decade of life	First decade of life	First decade of life
Heredity	Autosomal dominant	Autosomal recessive	Autosomal dominant
Reduced vision	Fourth or fifth decade of life	First or second decade of life	Second or third decade of life
Erosions	Uncommon	Common	Frequent
Opacities	Discrete, intervening stroma Clear, not to limbus	Indistinct margins, intervening Stroma hazy, extends to limbus	Refractile lines and dots Usually not to limbus
Material	Hyaline	Glycosaminoglycans	Amyloid

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Author

Danielle Trief, MD Assistant Professor of Ophthalmology, Columbia University College of Physicians and Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Jonathan D Fay, MD Cornea Fellow, Department of Ophthalmology, Columbia University College of Physicians and Surgeons

Jonathan D Fay, MD is a member of the following medical societies: American Academy of Ophthalmology

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, Sidney Kimmel Medical College of Thomas Jefferson University; Director of the Cornea Service, 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, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: AAO; OMIC; American Society of Ophthalmic Trauma (ASOT); Avellino, Baxis; Bio-Tissue; Celularity; Dompe; Emmecell; Glaukos; Kala; Oyster Point; Sun Ophthalmics; Tarsus; TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Glaukos; Dompe; Bio-Tissue<br/>Received research grant from: Glaukos<br/>Received income in an amount equal to or greater than $250 from: AAO; OMIC; Baxis; Bio-Tissue; Cellularity; Dompe; Glaukos; Kala; Sun Ophthalmics; TearLab<br/>stock options for: RPS, Fount Bio.

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

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.

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.

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.

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.

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

Disclosure: Nothing to disclose.

Lattice Corneal Dystrophy Medication

Medication Summary

Hypertonic saline

Class Summary

Sodium chloride hypertonic, ophthalmic (Muro 128)

Sodium chloride hypertonic, ophthalmic (Muro 128)

Lubricating drops

Class Summary

Artificial tears (GenTeal, Refresh, Bion tears)

Artificial tears (GenTeal, Refresh, Bion tears)

Lattice Corneal Dystrophy Medication

Medication Summary

Hypertonic saline

Class Summary

Sodium chloride hypertonic, ophthalmic (Muro 128)

Sodium chloride hypertonic, ophthalmic (Muro 128)

Lubricating drops

Class Summary

Artificial tears (GenTeal, Refresh, Bion tears)

Artificial tears (GenTeal, Refresh, Bion tears)

References

Tables

Contributor Information and Disclosures

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