Phenotypic Variability Of Lattice Corneal Dystrophy: A Familial Case Series From A National Tertiary Center In The Philippines

To describe the diverse phenotypic presentations of Lattice Corneal Dystrophy within a single Filipino family and evaluate the surgical outcomes of Penetrating Keratoplasty among the members of the family with advanced cases.

The cases were seen at the Department of Health Eye Center, a tertiary eye center and the National Referral Center for Eye Care in the Philippines.

We present a series of four siblings with clinically evident lattice corneal dystrophy. An older sister and brother presented with debilitating bilateral stromal opacities and recurrent corneal erosions . The brother’s case was complicated by corneal bullae and significant thickening on optical biometry. Both underwent Penetrating Keratoplasty combined with Cataract Extraction and Intraocular Lens Implantation . Postoperatively, both achieved a significant gain in Best Corrected Visual Acuity.  Following the index cases, two younger sisters were screened, revealing subclinical central stromal opacities and pathognomonic fine refractile lattice lines. Unlike their older siblings, they maintain functional vision and are currently managed conservatively with lubricants for comfort and prevention of further complications of lattice corneal dystrophy

This series underscores the high penetrance and variable expressivity of lattice corneal dystrophy within a single family. While the Triple Procedure remains a highly effective intervention for restoring vision in advanced LCD complicated by cataracts, early identification of younger family members is necessary. Active surveillance allows for the management of ocular surface disease before the onset of irreversible corneal decompensation, highlighting the necessity of genetic counseling in the Filipino setting.