Macular Corneal Dystrophy – The Final Decision.
Published 2024 - 42nd Congress of the ESCRS
Reference: PO898 | Type: Poster | DOI: 10.82333/tym8-sr33
Authors: Iryna Pshenychna* 1 , Kateryna Hrizhymalska 1 , Olga Andrushkova 1 , Yulia Saldan 1 , Nelia Kryvetska 1 , Tetiana Zhmud 1
1Ophthalmology,National Pirogov Memorial Medical University, Vinnytsya,Vinnytsia,Ukraine
Purpose
To present a clinical case of an accidental finding of macular corneal dystrophy. To assess the expediency of excimer laser vision correction or further use of soft contact lenses when macular dystrophy of the cornea is detected.
Setting
A 28 y.o. woman with complaints about: low vision acuty from the childhood, blurred vision, lacrimation, light sensitivity made an appointment regarding the possibility of excimer laser vision correction. Over the past year, the vision has subjectively worsened. The patient associates the decrease in visual acuity with changing of a workplace, where she spends a long time at the computer every day. For many years she uses monthly replacement soft lenses.
Methods
Autorefractokeratometry, BCVA, Slit Lamp Biomicroscopy, Indirect Ophthalmoscopy, Fluorescein Eye Stain Test, Anterior segment optical coherence tomography (AS-OCT), Corneal Topography.
Results
Multiple plaque-like clouding of the cornea over the entire surface and depth. Negative Fluorescein Eye Stain Test. Instability of the tear film due to a decrease in the lipid layer and the thickness of the tear meniscus. Pachymetry: 519/543 μm. Visual acuity was 0.05 in both eyes. BCVA of the right eye: sph. -6,5 cyl. -1,0 ax. 50 ° = 0,5. BCVA of the left eye: sph. -6,5 = 0,5. The diagnosis was established: High myopia of the right eye. Moderate myopia of the left eye. Compound myopic astigmatism of both eyes. Refractive amblyopia of both eyes. Macular corneal dystrophy of both eyes (greater manifestations on the right eye). Dry eye disease due to lipid deficiency.
Conclusions
Excimer laser vision correction is not be useful, such as this procedure have limited benefits in addressing vision loss in the case associated with macular corneal dystrophy. Recommended to choosing eyeglasses instead contact lenses for vision correction. Dynamic topography analysis of the cornea semiannually. Prescription tear replacement drug must be strengthened by adding keratoprotectors. It can be useful in treatment dry eye didease complicated by corneal dystrophy.