Treatment of band keratopathy by excimer laser phototherapeutic keratectomy: surgical techniques and long term follow up.
A series of 122 eyes with band keratopathy was treated by excimer laser phototherapeutic keratectomy (PTK), with a mean follow up of over 12.3 months (range 3 to 60 months). A single photoablation zone was used to remove the opacity over the visual axis in smooth surfaced band deposition. In eyes with reduced vision, an improvement was reported in 88% and in a series of 66 eyes mean Snellen visual acuity increased significantly (p < 0.05, t = 2.27). A reduction in glare was reported in 88% and in a series of 17 patients, visual contrast sensitivity (p < 0.01) and measurements of disability glare (p < 0.01) improved postoperatively. The mean hyperopic shift in 32 eyes at 6 months was 1.4 D (range 0-4.25 D). Multiple overlapping ablation zones, with mechanical debulking of large calcium plaques, were used to smooth the irregular corneal surface in eyes with rough bands. Ocular discomfort was improved in 95%. Band keratopathy recurred in nine eyes (8%) within 2 to 30 months (mean 12 months) of surgery, with silicone oil responsible in five eyes. Reablation was necessary in three eyes and performed successfully in all cases. Excimer laser PTK is a safe and effective outpatient treatment for band keratopathy.
O'Brart
D P
DP
Department of Ophthalmology, St Thomas's Hospital, London.
Gartry
D S
DS
Lohmann
C P
CP
Patmore
A L
AL
Kerr Muir
M G
MG
Marshall
J
J
D000328:Adult; D000368:Aged; D003315:Cornea / Q000473:pathology / Q000601:surgery; D003318:Corneal Opacity / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence