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Treating Avellino Corneal Dystrophy With a Conjunctival Flap Over the Mid–Peripheral Cornea

¹ Ophthalmic Research, Emory University Eye Center, Atlanta, GA
² Department of Ophthalmology, Yonsei University, Seoul, Republic of Korea

Commercial Relationships: S.M. Cristol, None; S. Chung, None; W. Kim, None; S. Choi, None; R. Stulting, None; H. Lee, None; E. Kim, None.

Support: None.

Abstract

Purpose: To assess the short term safety and efficacy of treating Avellino corneal dystrophy (ACD) with a mid–peripheral conjunctival flap. This approach was suggested by observations in a 20 year old Korean female patient with heterozygous ACD. She had numerous fine, white, granular deposits in her right anterior stroma but no deposits in her left cornea which had 120° neovascularization at the limbus with 360° conjunctival injection.

Methods: Three heterozygous ACD patients, each with an eye with accelerated deposition after LASIK, had a conjunctival flap attached to the superior cornea 3 mm from the pupil center with (n=1) or without (n=2) removal of the LASIK flap. One homozygous patient (Patient "A") had phototherapeutic keratectomy (PTK) in each eye and superior and inferior mid–peripheral conjunctival flaps in one eye. Three eyes of two other homozygous patients had conjunctival flaps attached to the superior and inferior cornea 3 mm from the pupil center; all three eyes had previously been treated with PTK.

Results: Within two weeks of the flap placement, all eyes of heterozygous ACD patients showed some reduction in ACD deposits near the conjunctival flap. Patient "A" had minimal recurrence in the eye with the flaps after 5 months while moderate recurrence had been noted in the fellow eye after only 2 months. The three eyes of the other two homozygous patients showed clearance of deposits near the edge of the conjunctival flap.

Conclusions: Mid–peripheral conjunctival flaps can reverse ACD deposits and delay recurrence over short time intervals. It seems likely that this is related to the vascularity of the conjunctiva.

Key Words: degenerations/dystrophies • cornea: stroma and keratocytes

© 2005, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any part of this abstract, contact the ARVO Office at arvo{at}arvo.org.