Phototherapeutic keratectomy for recurrent corneal erosions.
Recurrent corneal erosion may be a difficult disorder to treat, with a number of patients suffering persistent symptoms despite conventional therapy. We present a series of 15 patients (17 eyes) who underwent excimer laser phototherapeutic keratectomy (PTK) for recurrent corneal erosion. In 9 patients a previous episode of corneal trauma could be identified, while in 6 (8 eyes) the problem had occurred spontaneously. The mean duration of symptoms prior to PTK was 13 months (range 6-60 months). All patients had received lubricant ointments, 7 had tried bandage contact lenses and 4 had undergone epithelial debridement with no amelioration of their symptoms. The affect area of epithelium was removed and a 20-30 pulse (5-7 microns) ablation was performed to Bowman's membrane. Great care was taken to avoid the edges of treatment zones from encroaching on the axial cornea. In 11 patients (13 eyes) there was a marked improvement in symptoms post-operatively with no recurrences. The mean follow-up was 11 months (range 6-24 months). Four patients experienced recurrent episodes 3-6 months after PTK and 2 have subsequently been retreated, 1 of whom has been symptom-free for 12 months. Post-operative best corrected visual acuity was unaltered in 9 eyes and improved by at least one Snellen line in 8 eyes. Excimer laser PTK appears to be a safe and promising procedure for recurrent corneal erosion in cases refractory to medical treatment. Further studies are indicated to compare its effectiveness with established surgical procedures.
O'Brart
D P
DP
United Medical School, Department of Ophthalmology, St. Thomas' Hospital, London, UK.
Muir
M G
MG
Marshall
J
J
D000328:Adult; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D004728:Endothelium, Corneal / Q000601:surgery; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome; D014792:Visual Acuity