Analysis of the efficacy and safety of excimer laser PTK in the treatment of corneal disease.
In this study, we report our clinical experiences and results in performing 193-nm argon fluoride excimer laser phototherapeutic keratectomy (PTK) on 48 eyes of 45 patients with various pathology in the anterior one-third of the cornea, including leukoma, stromal dystrophy, anterior basement membrane dystrophy, and Salzmann's nodular degeneration. The VISX model 20/20 laser was used to ablate the anterior stroma to variable depth, dependent upon pathology. Patients were followed for a minimum of 1 year. Per an FDA-approved protocol vision, refraction, comfort, clarity, rate of reepithelialization, and complications were monitored. Seventy-two percent of patients undergoing excimer laser ablation for visual recovery had documented improvement in Snellen acuity. For the same period, 70% of those patients who were symptomatic prelaser were noted to be more comfortable. Corneal clarity improved in 35 of 48 eyes (73%), remained stable in nine (19%), and worsened in four (8%). Complications arose in 8% and included recurrence of herpetic keratouveitis, episcleritis, and an attack of narrow angle glaucoma secondary to cycloplegic agents. Delayed reepithelialization, >7 days, was noted in nine patients (19%). All complications were successfully treated medically. Excimer PTK appears to be a valuable addition to our therapeutic armamentarium for the treatment of superficial stromal opacification and surface irregularity.
Cornea Research Laboratory, University of Rochester Medical Center, New York, USA.
S J
SJ
Zuckerman
J V
JV
Aquavella
S B
SB
Park
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000503:physiopathology; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D004848:Epithelium / Q000503:physiopathology; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000009:adverse effects; D012029:Refraction, Ocular; D012449:Safety; D016896:Treatment Outcome; D014785:Vision, Ocular; D014792:Visual Acuity; D014945:Wound Healing