Excimer laser phototherapeutic keratectomy for recurrent corneal erosion

Abstract

Excimer laser PRK appears to be a safe and effective treatment for recurrent erosions of the cornea.

Ten-year results of phototherapeutic keratectomy on recurrent corneal erosions

“…A literature review was completed to look at long term follow-up of PTK for RCES. In this study, with a mean follow-up of 12 ± 1.52 years (range, 10 to 14 years), we report the longest follow-up after PTK for RCES compared to other studies (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . Overall our results may contribute to establish the very long term success of this technique.…”

“…Excimer laser, with its facility to ablate corneal tissue with extreme precision and minimal adjacent tissue damage has been a useful tool in the management of RCES (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . Studies have shown that partial ablation of Bowman's layer gives a smooth bed for migrating epithelium, and results in new hemidesmosomal adhesion complexes (20,21) .…”

“…These methods have recurrence-free rates of 80 to 100% during follow-ups ranging from 4 to 33 months (3)(4)(5)(6) . Although less costly, surgical methods that penetrate Bowman's layer and the stroma carry the risk of creating corneal scars or perforating the cornea (3) , as opposed to the extreme safety reported for PTK (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . In this case series, all patients underwent extensive conventional therapy at our institution before PTK.…”

“…It is not known to what extent the decrease in hemidesmosomes and anchoring fibrils formation can cause clinically significant corneal erosion. However, this may contribute to symptoms like foreign body sensation on awakening and the recurrence of painful corneal erosions in some of the eyes after PTK (9,17,18) . Besides effectiveness of the laser ablation, large beam cross-sections, typically several millimeters in diameter, allow simultaneous treatment of wider areas.…”

“…Several methods of surgical treatment have been shown to be helpful including epithelial basement membrane debridement (3,4) , super ficial keratectomy with a diamond burr (5) , anterior stromal puncture by sharp needles (4) , and Nd:YAG laser (6) . Also, several authors have reported the use of excimer phototherapeutic keratectomy (PTK) for this condition (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . Reported success rates with PTK have varied from 69% to 86% (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) .…”