4.4 Editorial Material

Clearing the Haze: Navigating Corneal Refractive Surgery in Patients with Posterior Polymorphous Corneal Dystrophy

Journal

OPHTHALMOLOGY AND THERAPY
Volume 10, Issue 3, Pages 383-387

Publisher

SPRINGER INTERNATIONAL PUBLISHING AG
DOI: 10.1007/s40123-021-00364-z

Keywords

Ectasia; Endothelial cell density; LASIK; PPCD; PPMD; PRK; Refractive surgery; SMILE

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Funding

  1. Research to Prevent Blindness, New York, USA

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Corneal refractive surgery in patients with PPCD poses risks that need to be carefully considered. Proceeding with surgery may compromise corneal integrity, affecting the stability and health of the cornea.
Posterior polymorphous corneal dystrophy (PPCD) is a corneal disorder of the endothelium and Descemet's membrane. Although reports of corneal refractive surgery including laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and small incision lenticule extraction (SMILE) in PPCD are minimal, these procedures have been shown to be safe and effective in this patient population. Proceeding with corneal refractive surgery in eyes with PPCD raises concerns regarding corneal integrity, including long-term biomechanical instability, risk of ectasia, endothelial cell loss, disease progression, and corneal decompensation. Thus, LASIK, PRK, and SMILE should be considered with caution. This commentary explores the patient characteristics associated with favorable surgical outcomes and factors that weigh against proceeding with refractive surgery.

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