Management of band keratopathy with excimer phototherapeutic keratectomy: visual, refractive, and symptomatic outcome.
OBJECTIVE
To report on the outcome of excimer phototherapeutic keratectomy (PTK) in the management of band keratopathy.


METHODS
Analysis was performed on patients undergoing PTK for band keratopathy between January 1996 and December 1999. Patients were assessed as to whether the indication for PTK was for visual rehabilitation (visual group) or for ocular surface improvement (nonvisual group). Further data including pre- and postoperative best-corrected visual acuity, pre- and postoperative spherical equivalent (SE), and associated or previous ocular pathology were collected.


RESULTS
A total of 45 eyes of 33 patients underwent PTK for band keratopathy. In the visual group, there were 33 eyes of 22 patients, and in the nonvisual group 12 eyes of 11 patients. The visual acuity was improved or unchanged in 18/33 eyes (55%) of the visual group, while there was loss of one or more lines of acuity in 15/33 (45%). Loss of acuity was attributed to other factors in 11/15 eyes. There was a significant myopic shift (P<0.5) from the mean preoperative SE of +1.42 D (SD+/-3.21 D) to the mean postoperative SE of +0.32 (SD+/-3.26 D). Of the eyes in the nonvisual group, 10/12 (83%) had significant improvement of symptoms.


CONCLUSIONS
Excimer PTK is an effective procedure in the management of band keratopathy whether it is performed for visual rehabilitation or for ocular surface improvement to prevent erosions. Concurrent pathology is common and may limit the extent of visual improvement postoperatively. Factors associated with the myopic shift seen in this series may be epithelial remodelling, concurrent ocular pathology, or inaccuracy of preoperative refractive data.
Stewart
O G
OG
Department of Ophthamology, St James University Hospital, Leeds, West Yorkshire, UK. owenstewart@fsmail.net
Morrell
A J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications / Q000503:physiopathology; D002387:Cataract Extraction; D003315:Cornea / Q000473:pathology; D003316:Corneal Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D003930:Diabetic Retinopathy / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D018579:Patient Selection; D018903:Photorefractive Keratectomy; D016896:Treatment Outcome; D014792:Visual Acuity