Abstract

32-year-old lady presented with Reis-Bucklers’ corneal dystrophy in both eyes. Slit lamp examination showed dense diffuse greyish deep epithelial opacities involving the visual axis in a fishnet pattern. AS-OCT imaging of cornea showed a thick band of hyperreflective material in the epithelial and subepithelial area which was 158 microns thick in RE and 144 microns thick in LE.
PTK was planned for visual rehabilitation. Overall depth of the central corneal opacity due to Reis-Bucklers’ dystrophy in our case was about 150 microns. Residual clear stroma beneath the opacity was measured to be around 480 microns.
Advanced cases of Reis-Bucklers’ corneal dystrophy, deposits replacing the basal epithelial cells are accumulated over time. This provides additional thickness to the anterior cornea with relatively uninvolved mid to deep stroma. Hence in these cases, PTK with higher ablation depth can be planned safely as it will ablate the added deposits and not deep into the stroma.