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K Kawamoto; Delayed Corneal Epithelial Wound Healing After Penetrating Keratoplasty for Lattice Corneal Dystrophy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4246.
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Purpose:To investigate whether corneal epithelial disorders in individuals with lattice corneal dystrophy (LCD) are caused by the epithelium or the stroma, we evaluated epithelial wound closure in LCD patients after penetrating keratoplasty (PKP). Methods:The clinical course of corneal epithelial wound closure after PKP was examined retrospectively on the basis of medical charts. All cases of PKP for LCD (six men and three women, aged 24 to 80 years with a mean of 50.5 years), keratoconus (five males and seven females, aged 15 to 60 years with a mean of 27.7 years), and corneal leukoma (three men and seven women, aged 49 to 78 years with a mean of 68.0 yeras) that took place in Yamaguchi University Hospital between February 1998 and February 2001 were evaluated. Cases associated with any disorders that might affect epithelial wound healing, such as eyelid abnormalities, hypolacrimia, corneal hypesthesia, diabetes mellitus, and rheumatoid arthritis, were excluded. Results:The time required for complete epithelial resurfacing after PKP was 8.9 ± 4.5 (mean ± SD), 3.3 ± 4.1, and 2.8 ± 2.0 days in individuals with LCD, keratoconus, or leukoma, respectively. The difference between healing time for the LCD group and either the keratoconus group (P < 0.05) or the corneal leukoma group (P < 0.01) was statistically significant (Steel Dwass test). Two healing patterns were apparent in LCD patients: rapid and prolonged. Whereas healing was complete within 4 days in three LCD patients, it required 9 to 14 days in the remaining six patients. Conclusion:Corneal epithelial defects persist in LCD patients after PKP, in which the corneal stroma is replaced. These observations suggest that the corneal epithelial disorder in LCD might be caused by epithelial factors, even though LCD is considered a stromal corneal dystrophy.
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