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S. Roters, M. Severin, W. Konen, G.K. Krieglstein; Prevention of granular corneal dystrophy recurrence with soft contact lenses – a long–term follow–up . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1530.
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Purpose: To prevent recurrence of granular corneal dystrophy that is usually treated surgically. The underlying disease recurs after various intervals irrespective of treatment method. Methods: We report the cases of 2 patients after penetrating keratoplasty (pk) and the follow–up by treatment with soft contact lenses (cl). Results:Patient 1, male, familiar granular dystrophy: pk at the age of 54 (1982) followed by cataract extraction 16 month later. Aphakia was corrected with a soft contact lens (+13.0 dptr., 70% content of water, daily wear 12–14 h). At last follow–up, 19 years later, the corneal transplant was clear without a sign of recurrence. The fellow eye was implanted with an intraocular lens after cataract extraction, and therefore no contact lens was used in this eye. This eye showed reappearance of granular dystrophy 7 years after penetrating keratoplasty. Patient 2, female, familiar granular dystrophy: after pk at the age of 61 (1998) a contact lens (+0 dptr., DK 26.7, 70% content of water) was fitted and worn continously. No sign of recurrence could be shown in the specified observation period totaling 66 months. However, the other eye, which was operated first and not treated with a contact lens, showed severe recurrence of the underlying disease, with granular deposits in the stroma 4 years after pk. Conclusions:Fitting of hydrophilic contact lenses was the crucial measure first published 1991 by HU Moller with reduced inclusion of granular lesions irrespective of keratoplasty. The effect of soft contact lenses in treatment and prevention of amiodaron keratopathy is also known. The interaction is speculative by which a soft contact lens acts to avoid or minimize a recurrence of granular deposits. Changes include hypoxia, acidosis, reduction in cell regeneration and interference with the tear film. If further observations were to indicate that therapeutic contact lenses prevent a dystrophy, that would be of major relevance to therapy.
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