Potential of phototherapeutic keratectomy in the treatment of lisch epithelial corneal dystrophy

Abstract

Background. Lisch epithelial corneal dystrophy (LECD) is a rare inherited corneal dystrophy characterized by the development of intraepithelial microcystic changes forming characteristic whorled, band-shaped, feather-like, or club-shaped patterns. Due to the rarity of the disease, evidence regarding the effectiveness of available treatment options, longterm outcomes and recurrence rates remains limited. Purpose. To present the outcomes of phototherapeutic keratectomy (PTK) in a patient with Lisch epithelial corneal dystrophy. Material and Methods. A clinical case of a 42-year-old woman with LECD is presented. Preoperative and postoperative examinations included corrected distance visual acuity (CDVA), autorefraction, non-contact tonometry, anterior segment optical coherence tomography (AS-OCT) with epithelial thickness mapping and corneal tomography. Transepithelial PTK was performed using the WaveLight EX500 excimer laser system (Alcon, USA). The follow-up period was 3 months. Results. PTK resulted in restoration of corneal transparency and regularization of the anterior corneal surface, accompanied by an improvement in corrected distance visual acuity from 0.8 to 1.0. AS-OCT demonstrated complete resolution of the hyperreflective intraepithelial microcystic lesions and normalization of the epithelial profile. Corneal tomography confirmed regularization of the anterior corneal surface. No signs of recurrence were observed during the 3-month follow-up period. Conclusions. This clinical case demonstrates the feasibility of successful PTK for the treatment of Lisch epithelial corneal dystrophy. The procedure restored corneal transparency, improved visual function, and resulted in a favorable clinical outcome. Further follow-up and accumulation of clinical experience are required to evaluate the long-term efficacy and durability of this treatment approach.