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1、FeaturesofRecurrenceafterExcimerLaserPhototherapeuticKeratectomyforAnteriorCornealPathologiesinNorthChinaMinChen,MD,PhD,LixinXie,MDPurpose:Tostudylong-termclinicalpatternsofrecurrenceofanteriorcornealpathologiesafterexcimerlaserphototherapeutickeratectomy(
2、PTK).Design:Retrospective,noncomparative,interventionalcaseseries.Participants:Thirtypatients(44eyes)withanteriorcornealpathologieswhounderwentPTKandexperi-encedrecurrenceafterlong-termfollow-upbetweenMarch1997andApril2012.Preoperativediagnosesincludedband
3、keratopathyin7eyes,anteriorbasementmembranedystrophy(ABMD)in8eyes,granulardystrophyin15eyes,latticedystrophyin10eyes,andmacularcornealdystrophy(MCD)in4eyes.Methods:DataofeachpatientwerecollectedregardingtherecurrenceofprimarydiseaseafterPTK.RTVue(Optovue,I
4、nc.,Fremont,CA)opticalcoherencetomography(OCT)wasusedtodetectthedepthofrecurrentdeposits.Confocalmicroscopywasusedtoevaluatethecellularalterationsassociatedwithrecurrentcornealdisease.MainOutcomeMeasures:Interval,location,morphologyoftherecurrence,depthofr
5、ecurrentdeposits,andcellularalterationsinrecurrentdisease.Results:Themeanfollow-up(fromthefirstPTKtothelastvisit)was95months(range,80–120months).Thediseaserecurrencewassymptomaticinall8eyestreatedforABMDand2eyestreatedforlatticedystrophyandasymptomaticinthe
6、othercases.Significantrecurrenceofbandkeratopathy,ABMD,MCD,latticedystrophy,andgranulardystrophydevelopedatanaverageof7.8,12.4,13.5,19.7,and23.7monthsafterPTK,respectively.RTVueOCTimagesindicatedthattherecurrentdepositsinvolvedtheanteriorcornealstroma(80–15
7、0m)andweremainlywithin8mmaroundthecornealcenter.Morphologicchangesincludeddisorganizedstromalfibers,decreaseddensityanddisorderedarrangementofnervefibers,andinconspicuouskeratocytenuclei,occasion-allyaccompaniedbydecreasedkeratocytedensityandendothelialcell
8、density.Conclusions:ThefeaturesofdiseaserecurrenceafterPTKarecloselyrelatedtotheoriginalcornealpathology.Recurrenceinthisserieswasfastestinpatientswithbandkeratopathyand,sequentially,ABMD,MCD,latticedystrophy
