Phototherapeutic keratectomy versus alcohol epitheliectomy with mechanical debridement for superficial variant of granular dystrophy: A paired eye comparison

Abstract Purpose To compare outcome of phototherapeutic keratectomy (PTK) and alcohol epitheliectomy with mechanical debridement for superficial variant of granular dystrophy. Method Case report. A 7 year old girl with superficial variant of granular dystrophy with an visual acuity of 20/70 both eyes, underwent a simultaneous PTK in right eye (OD) and alcohol epitheliectomy with mechanical debridement in left eye (OS). Post operatively the visual acuity, refraction and corneal clarity were assessed. Results On the first post-operative day uncorrected visual acuity was 20/50 in both eyes. At 2 weeks, vision improved to 20/40 with +2.50 −2.00 × 180 in OD and +1.50 −1.50 × 180 in OS. At 2 years, vision and refraction were 20/25 with +2.50 −2.00 × 180 in OD and 20/25 with +1.25 −1.50 × 170 OS respectively. There was early recurrence of the granular dystrophy. Conclusion The visual outcomes of both PTK and alcohol epitheliectomy are similar for superficial variant of granular dystrophy. The hyperopic shift with PTK is a matter of concern. Alcohol epitheliectomy can be used in treatment of superficial corneal dystrophies where PTK is unavailable.