Ten-year results of phototherapeutic keratectomy on recurrent corneal erosions

Abstract

Purpose: To determine the ten-year visual results and outcomes of excimer laser pho totherapeutic keratectomy (PTK) for recurrent corneal erosions. Methods: Twenty-six eyes of 23 patients with recurrent corneal erosions were treated by PTK from 1996 to 2000 at the Goiania Eye Institute, Brazil. All eyes had failed to respond to conventional therapy. Data regarding preoperative and postopera ti ve best-spectacle-corrected visual acuity (BSCVA), spherical equivalent (SE), sympto matic relief, incidence of recurrence, and complications arising from the laser treatment were analyzed. The mean duration of symptoms prior to PTK was 18 months (range, 8 to 36 months). The corneal epithelium was debrided, and laser ablation was performed to a depth of 5 micron with an ablation zone of 7 to 9 mm, using the Technolas 217C Plano Scan excimer laser. Mean postoperative follow-up was 12 years (range, 10 to 14 years). Results: At the last follow-up visit, 15 eyes (57.69%) were symptomsfree. Five eyes (19.2%) had occasional mild symptoms of irritation and photophobia upon awakening. Recurrence of painful corneal erosions occurred in six eyes (23.07%), which required a PTK retreatment. Twenty-four eyes had a preserved or improved BCVA, while 2 eyes showed deterioration of 1 line on Snellen test. Eleven eyes (42.3%) had no change in SE, and the others (57.69%) had a change of less than +/-0.75 diopters (D). There were no major complications during the follow-up period. Conclusion: Ten-year data show that PTK is a safe, fast, effective and minimal invasive choice of treatment for recurrent corneal erosions in patients who do not respond to conventional treatments.

Clinical outcomes and time to recurrence of phototherapeutic keratectomy in Japan

“…[1–5] Using the PTK technique, superficial corneal opacification can be ablated, leaving the clear underlying stroma undisturbed. The PTK can be recommended in cases of corneal dystrophies, [2,6–9] band keratopathy (BK), [10] recurrent corneal erosion, [11–13] and certain types of degenerative corneal diseases. [14–16] PTK is thought to be a minimally invasive therapy for an anterior corneal pathology.…”

Transepithelial phototherapeutic keratectomy for post-traumatic recurrent corneal erosions

“…[ 1 ] PTK is performed with manual removal of the loosely adherent epithelium, followed by ablation of the abnormal basement membrane and superficial stroma using excimer laser (193 nm). [ 17 ] A 10-year study showed that recurrence of painful corneal erosions occurred in 6 eyes (23.07%) after PTK, which required a PTK retreatment. The mean change in spherical equivalent manifest refraction was +0.08 ± 0.30 D compared to the preoperative refraction.…”

Phototherapeutic keratectomy

“…Recurrent corneal erosions can be seen in association with corneal dystrophies such as EBMD and LCD or they can be nondystrophic in origin, developing after trauma, or be idiopathic in nature. 129 Clinically they present with acute episodes of pain, lacrimation, and photophobia, usually at night or upon awakening. 199 Conservative treatment options help in temporarily alleviating symptoms but do not alter the underlying disease process.…”

“…28 Studies of PTK performed for RCEs report high recurrence rates in the eyes with nontraumatic origin of erosions attributed to an underlying corneal dystrophy. 20,67,129 Recurrence rates range from 0 to 42%, 20,28,67,144,182 with a recurrence-free interval ranging from as early as 6 to 9 months 20,33,50,111,171 to up to 21 months 15 after treatment.…”