Phototherapeutic keratectomy in pediatric patients in India.
OBJECTIVE
To study the outcome of phototherapeutic keratectomy (PTK) in children younger than 16 years, with corneal scars, dystrophies, and band-shaped keratopathy.


METHODS
Records of 18 eyes of 14 patients younger than 16 years who had undergone PTK were retrospectively reviewed. Pre- and post-PTK visual acuity, corneal clarity, and need for additional surgery were noted. Flying spot and broad beam laser machines were used for PTK.


RESULTS
PTK was performed on 18 eyes of 14 patients; PTK was performed to treat scars (n = 8 eyes), band-shaped keratopathy (n = 5 eyes), and granular dystrophy (n = 5 eyes) for reduced vision. In addition, 1 patient had irritation, watering, and photophobia. All these patients had a clear visual axis after PTK. Refraction was possible only in 6 eyes before PTK; with increased clarity of the visual axis, it was possible in 15 patients after PTK. Before PTK, mean best-corrected logarithm of minimum angle of resolution visual acuity (Snellen equivalent) was 1.13 (20/250) and SD 0.92 (20/160); after PTK, it was 0.47 (20/60) and SD 0.37 (20/50) (P = 0.001). The primary disease recurred in 3 patients: granular dystrophy in 2 eyes, and scar along with Salzmann nodular degeneration in 1 eye. PTK was repeated in all 3 with good visual and symptomatic outcomes. None of these patients had infection or raised intraocular pressure.


CONCLUSIONS
PTK is a safe and effective procedure in children. After PTK, corneal clarity is enhanced, facilitating accurate refraction and leading to improved visual acuity in most eyes. PTK can be safely repeated in case of recurrence.
Rathi
Varsha Madanlal
VM
Cornea and Refractive Surgery Services, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India. varsharathi@lvpei.org
Vyas
Sharadini Prateep
SP
Vaddavalli
Pravin Krishna
PK
Sangwan
Virender S
VS
Murthy
Somasheila I
SI
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007194:India; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D018903:Photorefractive Keratectomy; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology