basement membrane dystrophy

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basement membrane dystrophy

Postby rsinsabaugh » Wed Aug 30, 2006 4:06 pm

Does basement membrane dystrophy preclude LASIK? If not, what are risks?
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Postby LasikExpert » Wed Aug 30, 2006 7:54 pm

Corneal epithelial basement membrane dystrophy (EBMD), also known at map-dot-fingerprint corneal dystrophy, means that the outermost layer of cells of the cornea - the epithelium - are irregular and/or having difficulty holding on to the underlying corneal layers.

From the Review Of Ophthalmology Handbook of Ocular Disease Management:

"Approximately 10 percent of affected individuals develop transient blurred vision with painful recurrent epithelial erosions. Most patients experience fluctuating visual acuity without discomfort."

The corneal epithelium is in a distressed condition if EBMD is present. Even if discomfort or vision problems do not exist, EBMD has compromised the integrity of the cornea.

Any kind of surgery or management of the cornea can exacerbate EBMD. Asymptomatic patients may become symptomatic. Symptomatic patients may progress into vision disruptiong and painful recurrent corneal erosions, however for some cases photorefractive therapeutic keratectomy (PTK) is an appropriate surgical management technique. PTK is exactly the same as photorefractive keratectomy (PRK) - a refractive surgery technique to reduce the need for corrective lenses and the precursor to Lasik.

As a (very) general rule EBMD is a contraindication for Lasik and IntraLasik. EBMD is probably not appropriate for Epi-Lasik. EBMD may be indicated for PRK or LASEK.

If you suspect or have been diagnosed with EBMD, I highly recommend being evaluated by a cornea specialist before having any elective surgery.
Glenn Hagele
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