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Classic lattice corneal dystrophy: a brief review and summary of treatment modalities

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Abstract

Purpose

To provide a brief summary and comparison of the most recent literature on available and theorized treatment modalities for classic lattice corneal dystrophy (LCD). This paper aims to support practitioners in their management of this disease.

Methods

A search was carried out on available literature through PubMed and Google Scholar of English language articles up to January 2023 that relate to the treatment of LCD. Due to scarcity of literature regarding specific novel therapies for LCD, results from other corneal pathologies (granular corneal dystrophy, corneal scarring) are sometimes included for contrast, which is clearly denoted.

Results

LCD is a slowly progressive disease that leads to recurrent epithelial corneal erosions, stromal haze, corneal opacification, substantial discomfort, and visual impairment. Due to its autosomal-dominant inheritance pattern, this disease can persist throughout ancestral lines and requires consistent treatment and follow-up. An optimal management plan is necessary to (1) prolong years of life with best achievable visual acuity; (2) treat painful recurrent corneal erosions as they occur; (3) ensure proper follow-up throughout the life of a patient, as well as monitor at-risk offspring; and (4) monitor efficacy of treatment.

Conclusions

This paper addresses (1) treatment for early disease including corneal epithelial debridement, photo therapeutic keratectomy (PTK), femtosecond laser–assisted lamellar keratectomy (FLK), and others; (2) treatment for late disease including full thickness keratoplasties and anterior lamellar keratoplasties; and (3) potential future treatment considerations including a wide variety of topical/systemic, genetic, and regenerative approaches.

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Acknowledgements

We are grateful to Jayne S. Weiss, MD and Anthony J. Aldave, MD for their critical review and comments during the preparation of this manuscript. As well, we would like to thank Jeffrey Judelson, MD and Walter Lisch, MD for providing images for use in this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada

    Ekaterina Milovanova

  2. Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

    Stanislav Gomon

  3. Department of Ophthalmology & Visual Sciences, McGill University, Montréal, Canada

    Guillermo Rocha

Authors
  1. Ekaterina Milovanova
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  2. Stanislav Gomon
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  3. Guillermo Rocha
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Contributions

All authors contributed to the study conception and design. The first draft of the article was written by S. G., MD and G. R., MD. The final manuscript has been re-designed, completed, and edited by E. M., MD and G. R., MD. All authors have read and approved the final manuscript.

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Correspondence to Ekaterina Milovanova.

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Milovanova, E., Gomon, S. & Rocha, G. Classic lattice corneal dystrophy: a brief review and summary of treatment modalities. Graefes Arch Clin Exp Ophthalmol 262, 1667–1681 (2024). https://doi.org/10.1007/s00417-023-06297-6

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  • DOI: https://doi.org/10.1007/s00417-023-06297-6

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