Deep phototherapeutic keratectomy for Schnyder corneal dystrophy.

Abstract

We report a case of Schnyder corneal dystrophy (SCD) treated with deep phototherapeutic keratectomy (PTK). A 33-year-old man presented with a 5-year history of blurred vision and corneal haze in both eyes. Slit-lamp examination revealed needle-like subepithelial crystalline depositions and prominent arcus lipoides bilaterally. Similar clinical findings were observed in the patient's father. A diagnosis of SCD was made on the basis of the clinical presentation. PTK was performed using a multizone, multipass, and shoot and check technique with the WaveLight EX500 excimer laser. After 22 months of follow-up, the best-corrected visual acuity had increased from 0.5 to 0.9 in the right eye and from 0.3 to 0.9 in the left eye. SCD is rare but has a unique ocular presentation, which facilitates the diagnosis. PTK can increase patients' visual acuity and eliminate the need for aggressive management through penetrating keratoplasty or deep anterior lamellar keratoplasty.