[Photo-therapeutic keratectomy (PTK)--a successful treatment for Thiel-Behnke dystrophy and its recurrence].
In recent years good results after treatment of different superficial corneal pathologies with the excimer laser 193 nm have been reported. Thiel-Behnke dystrophy is a hereditary form of anterior stromal dystrophy, a promising layer for successful phototherapeutic keratectomy (PTK). This type of dystrophy was first described in 1967 in Kiel.


METHODS
Ten members of the original family of 1967 were re-examined at the University Eye Hospital, Kiel. A phototherapeutic keratectomy was performed in six eyes because of the typical honeycomb corneal surface irregularity and superficial haze. Two of these eyes had a recurrence of the primary disease on the graft. Four eyes had been untreated so far. The best spectacle corrected visual acuity preoperatively was between 20/200 and 20/40. For all treatments the MEL 60 excimer laser (Aesculap Meditec) was used. To even out the peaks and valleys of the irregular surfaces, modulating agents were applied in decreasing concentrations. The follow-up period is now between 8 months and 4 years.


RESULTS
All eyes showed significant visual improvement postoperatively with a best spectacle corrected visual acuity of 20/32 and higher. In one of the postkeratoplasty eyes with the longest follow-up after PTK, the original disease has begun to recur.


CONCLUSIONS
Phototherapeutic keratectomy is a successful therapy for Thiel-Behnke dystrophy; it results in quick recovery of patients and their vision. Stable visual acuity and corneal transparency have been observed that last for years. Recurrences after penetrating keratoplasty or after PTK can be positively retreated. A (re-) keratoplasty may be postponed or avoided.
Amm
M
M
Klinik für Ophthalmologie, Christian-Albrechts-Universität zu Kiel.
D003315:Cornea / Q000473:pathology / Q000601:surgery; D003317:Corneal Dystrophies, Hereditary / Q000473:pathology / Q000601:surgery*; D005139:Eyeglasses; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer; D018903:Photorefractive Keratectomy / Q000379:methods*; D011182:Postoperative Care; D012008:Recurrence; D014792:Visual Acuity