Phototherapeutic keratectomy

Abstract

Phototherapeutic keratectomy is an excimer laserebased surgical procedure widely performed by corneal surgeons for treating anterior corneal stromal pathologies. Phototherapeutic keratectomy helps by ablating the corneal stroma, thereby improving corneal clarity and smoothening the surface. Transient discomfort and induced hyperopia from corneal flattening are the immediate postoperative concerns. The long-term course is often marked by the recurrence of original corneal pathology and corneal haze formation. Phototherapeutic keratectomy, however, allows for repeat stromal ablation for managing recurrences, as the corneal thickness permits, without affecting the outcome of future keratoplasty. Adjunctive methods such as topical mitomycin-C may be additionally used to reduce recurrence rates. Also, various masking agents such as carboxymethyl cellulose, sodium hyaluronate, and dextran are used in eyes with irregular corneal surface to allow for uniform stromal ablation. Overall, phototherapeutic keratectomy has provided corneal surgeons an additional surgical tool, particularly those residing in developing nations where the availability of donor corneal tissue is an important limiting factor.

Phototherapeutic keratectomy for anterior stromal fibrosis following DMEK

“…Many different corneal pathologies like corneal dystrophies, anterior corneal scarring or recurrent corneal erosions can be treated by excimer laser based phototherapeutic keratectomy mainly by improving corneal clarity and smoothening the corneal surface. 4 In the literature only a few cases of PTK following DSAEK but not following DMEK have been described. In 2010 Hongyok et al 5 were the first ones who treated two patients with PTK including mitomycin C for anterior stromal fibrosis after DSEK.…”

Recent Advances in the Diagnosis and Management of Herpetic Keratitis

“…The PTK ablation should always be limited to anterior one-third of stromal layers and leave a minimum residual stromal bed thickness (RSBT) of 250 μm to avoid further corneal ectasia. Also, spontaneous reactivation of HSV keratitis is well known after PTK, because laser ablation stimulates viral shedding in tears and reactivates the virus [49,50].…”

Surgical outcomes of re-excimer laser phototherapeutic keratectomy (re-PTK)

“…Phototherapeutic keratectomy (PTK) is a surgical treatment for anterior corneal disease that involves the use of a 193-nm-wavelength argon fluoride excimer laser 1 . PTK can ablate superficial corneal opacification, such as in corneal dystrophy (CD) or corneal degeneration 2 , 3 .…”