Skip Navigation LinksHome > April 2011 - Volume 30 - Issue 4 > Treatment of Lisch Corneal Dystrophy With Photorefractive Ke...
Cornea:
doi: 10.1097/ICO.0b013e3181ec8e26
Case Report

Treatment of Lisch Corneal Dystrophy With Photorefractive Keratectomy and Mitomycin C

Wessel, Matthew M MD*; Sarkar, Jayati S MD*; Jakobiec, Frederick A MD, DSc†; Dang, Natasha MD‡; Bhat, Pooja MD†; Michaud, Norman BS†; Starr, Christopher E MD, FACS*

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Abstract

Purpose: To describe a case of Lisch dystrophy; review the clinical, histopathologic, and electron microscopic features of this entity; and discuss a novel treatment approach using photorefractive keratectomy (PRK) and mitomycin C (MMC).

Methods: A 45-year-old man with a feathery, comet-shaped, right-sided, corneal lesion was treated with excimer laser PRK and 20 seconds of MMC. The uninvolved fellow eye underwent traditional PRK without the use of MMC. Epithelial scrapings were sent for histopathologic analysis.

Results: Histopathologic analysis showed vacuolated cells in the epithelial layer. Electron microscopy revealed empty intracytoplasmic vacuoles, electron-dense whorled inclusions, and reduced tonofilaments. Surface ablation and MMC was successful in treating the initial lesion, with only minimal recurrence noted in the affected eye. Surprisingly, a new asymptomatic lesion was noted in the unaffected eye but dissipated over time.

Conclusions: Although the whorled inclusions represent a novel finding, the overall clinical and microscopic analysis was consistent with Lisch dystrophy. Surface ablation with MMC should be considered as a treatment option for this disease.

© 2011 Lippincott Williams & Wilkins, Inc.

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