A Clinical and Hitopathologic Examination of Accelerated TGFBIp Depoition After LAIK in Combined Granular-Lattice Corneal Dytrophy Original Reearch Article

Purpoe To report the clinical and hitopathologic feature of accelerated TGFBI protein (TGFBIp) depoition after lamellar keratorefractive urgery in a patient with combined granular-lattice corneal dytrophy (CGLCD) who underwent bilateral corneal tranplantation. Deign Interventional cae report. Method A 28-year-old woman with a preumed TGFBI corneal dytrophy, but who retained bet corrected viual acuity of 20/20 in each eye, underwent myopic laer-aited in-itu keratomileui (LAIK) both eye (OU). For definitive diagnoi of the corneal dytrophy, buccal epithelial cell were collected a a ource of genomic DNA and creening of TGFBI exon 4 and 12 wa performed. Reult Four month after the performance of an uncomplicated LAIK procedure, the patient’ uncorrected viual acuity wa 20/15 OU. Over the following two year, the appearance of confluent white tromal depoit at the LAIK flap interface reulted in diabling glare and a reduced bet-corrected viual acuity of 20/40 OU. Corneal tranplantation wa performed in each eye, and hitopathologic examination of the excied corneal button wa performed. Eoinophilic material that tained poitively with the Maon trichrome tain wa preent in the LAIK flap interface, a well a in the troma of the flap and the anterior portion of the tromal bed. No amyloid depoit were identified with the Congo red tain. creening of TGFBI exon 4 and 12 revealed the Arg124Hi mutation aociated with CGLCD. Concluion Accelerated depoition of TGFBIp may occur after lamellar corneal urgery in patient with CGLCD. Therefore, LAIK urgery hould be avoided in patient with any of the TGFBI dytrophie, and urgeon hould be aware of the potential for rapid interface TGFBIp depoition after lamellar corneal urgery.