Combined Keratectomy and Localized Limbal Cauterization for Treating Lisch Epithelial Corneal Dystrophy

To present a new technique for treating Lisch epithelial corneal dystrophy (LECD) in cases of recurrence of the disease.

We present a single case report of a 41-year-old man who presented to the cornea clinic with progressive loss of vision in the right eye. Slit-lamp examination showed a large white-gray whorl-like epithelial opacity connected to the limbus, which spread over the visual axis, affecting visual acuity. The left eye was uninvolved.

After epithelial debridement was performed, histological analysis showed the nonkeratinized stratified flat epithelium, coalescent cytoplasmic vacuoles in some keratinocytes, and isolated cells with granular cytoplasm and small PAS negative nuclei, which confirmed the diagnosis of LECD. Despite partially successful treatment with several sequential epithelial debridements, the patient presented with confirmed recurrence of the disease soon after every treatment. Thus, focal epitheliectomy combined with localized cauterization of the limbal focus of origin was performed. Vision returned to normal, and there were no signs of recurrence at final follow-up 2 years later.

Simple epitheliectomy combined with focal cauterization of the limbal focus of origin can be a simple, safe, and minimally invasive option for treatment of LECD.