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Y. Morita, N. Yamada, N. Morishige, T.-I. Chikama, T. Nishida; A New Mode of Treatment for Lattice Corneal Dystrophy Type I: Corneal Epithelial Debridement and Fibronectin Eyedrops. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3694.
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The R124C mutation of TGFBI gives rise to lattice corneal dystrophy type I characterized by irregularity, turbulence, and opacity of the corneal epithelium. We report that treatment of six eyes of four patients with the R124C mutation of TGFBI by corneal epithelial debridement resulted in an improvement in visual acuity.
Six eyes of four patients (25 to 57 years of age) treated between April 2006 and March 2008 were enrolled in the study. All patients experienced impaired visual acuity and recurrent corneal erosion. Informed consent was obtained from all patients before treatment. Corneal epithelial debridement was performed with a spatula at the pupillary zone. After debridement, eyedrops containing fibronectin purified from autologous serum were administered four times a day for 2 weeks to promote epithelial migration. Levofloxacin and fluorometholone were also applied four times a day for 1 month.
All corneas achieved resurfacing within a few days after debridement. The visual acuity of all eyes improved from an average of 0.16 (range, 0.04 to 0.2) to 0.77 (range, 0.5 to 0.9) by two to four months after debridement.
Corneal epithelial debridement followed by administration of fibronectin eyedrops is effective for improvement of visual acuity in cases of lattice corneal dystrophy type I caused by the R124C mutation of TGFBI. The treatment can be repeated safely and inexpensively and thus may delay progression of the pathology.
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