Purpose

Phototherapeutic keratectomy (PTK) with 193-nm excimer laser is a safe and effective procedure for the treatment of superficial corneal pathology. We aimed to review the use of PTK for the treatment of corneal macular dystrophy (MCD).

Methods

Case report and literature review

Results

A 16-year-old boy presented to an ophthalmologist with a 4-year history of reduced vision, glare and photophobia in his left eye. He was diagnosed with corneal macular dystrophy and underwent sequencing of the CHST6 gene. Left excimer PTK with mitomycin C was performed. He remained relapse free until 18 months post procedure when his visual acuity declined and the stroma appeared more “milky”. He underwent a penetrating keratoplasty in his left eye 24 month following the initial PTK.

Conclusion

Phototherapeutic keratectomy is an effective means of visual restoration in patients with macular corneal dystrophy and may delay penetrating keratoplasty. Patients should be counselled regarding the high risk of recurrence. This is the first reported case of a CHST6 gene positive patient with MCD that was treated with phototherapeutic keratoplasty.

中文翻译：

---

青春期角膜黄斑营养不良的双边光疗性角膜切除术：病例报告和文献复习。

目的

193 nm受激准分子激光的光疗性角膜切除术（PTK）是治疗浅表角膜病变的安全有效方法。我们旨在审查PTK在角膜黄斑营养不良（MCD）治疗中的应用。

方法

病例报告和文献复习

结果

一个16岁的男孩向眼科医生提出了4年的左眼视力降低，眩光和畏光的历史。他被诊断患有角膜黄斑营养不良，并接受了CHST6基因的测序。用丝裂霉素C进行左准分子PTK。直到手术后18个月，他的视力下降并且间质显得更“乳白色”，他仍保持无复发。最初的PTK后24个月，他的左眼进行了穿透性角膜移植手术。

结论

光疗性角膜切除术是黄斑角膜营养不良患者视觉恢复的有效手段，可能会延迟穿透性角膜移植术。应建议患者高复发风险。这是首次报道的CHST6基因阳性MCD患者，接受了光疗性角膜移植手术治疗。