Long-term management of gelatinous droplet dystrophy with phototherapeutic keratectomy and toric soft contact lenses

The aim of the study was to report the results of phototherapeutic keratectomy (PTK) and toric contact lens fitting for a young man with recurrent gelatinous droplet dystrophy (GDD) after penetrating keratoplasty (PK). A 21-year-old man was referred for pain, photophobia, and decreased vision. The patient who experienced decreasing vision for 15 years had under-gone PK 2 years ago due to GDD. He was having frequent recurrent epithelial erosions lately. Visual acuity (VA) was counting fingers at 3 m in the right eye and 0.8 in the left eye. Biomicroscopic examiantion revealed nodular dystrophic lesions on the nasal side of the graft in the right eye. Keratometric values were K1: 54.5, K2: 52.5 in the right eye and K1: 41.2, K2: 39.7 in the left eye. PTK was performed twice in the right eye and once in the left eye in 3 years. Final VA was 0.5 and 0.8 in the right and left eyes, respectively (with glasses and toric contact lenses) during 10 years of follow-up. A superficial corneal scar was noted on the right graft and the left cornea. No recurrence of dystrophy was observed. PTK decreases photophobia and provides visual improvement in patients with GDD and may help defer PK in case of recurrent GDD.