| Purpose: To evaluate the safety and efficacy of Automated Lamellar Therapeutic Keratoplasty (ALTK) for the treatment of recurrent granular dystrophy after phototherapeutic keratectomy.
Methods: We performed a prospective interventional non-comparative case study of nine eyes (seven patients) with severe recurrent granular dystrophy after treatment of PTK. An automated microkeratome was used to cut partial-thickness sections through the anterior surface of both the donor and host corneas. The donor disc was placed on the recipient bed with four or eight interrupted sutures. The stitches were removed between 4 and 6 weeks after surgery. Visual acuity, corneal clarity, corneal thickness, and corneal topography were assessed before and at different follow-up after surgery.
Results: During a follow-up period of 18.9±4.1 months, all grafts appeared to be transparent without recognizable opacity in the interface, and no serious complications were encountered. In all cases visual acuity was improved, 6 eyes had best corrected visual acuity better than 20/40, 2 eyes reached 20/25. At the last follow-up longer than 12 months postoperatively, the mean corneal refractive power significantly increased 2.34D±0.93D（P<.001）, and the corneal astigmatism significantly decreased 0.91D±0.98D（P<0.05）. The mean corneal thickness was 477.4±26.9μm preoperatively and 507.8±23.4μm at the last follow-up visits. The increase in corneal thickness was statistically significant (P<.001).
Conclusions: Our findings suggest that ALTK offers a safe, and repeatable way of restoring visual acuity in the treatment of recurrent granular dystrophy.
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