title: Excimer laser phototherapeutic keratectomy in eyes with corneal stromal dystrophies with and without a corneal graft.
abstract: OBJECTIVE
  To evaluate and compare the visual outcomes and recurrence patterns of corneal stromal dystrophies after excimer laser phototherapeutic keratectomy (PTK) in eyes with and without a corneal graft.
  
  
  METHODS
  Retrospective, comparative case series.
  
  
  METHODS
  setting: Cornea Service, Wills Eye Institute, Philadelphia Pennsylvania. study population: The patients were divided into 2 groups. Group 1 comprised patients with no graft who underwent PTK (22 eyes of 15 patients), and group 2 comprised patients who underwent PTK over a previous full-thickness graft (18 eyes of 14 patients). intervention: All patients underwent PTK for decreased vision, symptoms of recurrent erosions, or both. main outcome measures: Visual outcomes and recurrence patterns of corneal stromal dystrophies.
  
  
  RESULTS
  Preoperative and postoperative best-corrected visual acuities were 0.46 ± 0.25 and 0.51 ± 0.27 (P = .56), respectively, in group 1 and 0.16 ± 0.13 and 0.21 ± 0.18 (P = .25), respectively, in group 2. Mean preoperative spherical equivalent was 1.54 ± 2.59 diopters (D) and -5.10 ± 5.81 D (P = .01) in groups 1 and 2, respectively, and mean postoperative spherical equivalent was 0.44 ± 1.8 D and -1.8 ± 4.25 D (P = .19) in groups 1 and 2, respectively. There was no statistically significant difference in the efficacy (P = .73) and safety (P = .62) indices between the 2 groups. In group 1, mild recurrence was seen in 7 eyes (32%) and significant recurrence was seen in 4 eyes (18%) at a mean of 32 and 47 months after PTK, respectively. In group 2, mild recurrence was seen in 5 eyes (28%) and significant recurrence was seen in 5 eyes (28%) at a mean of 36 and 50 months after PTK, respectively.
  
  
  CONCLUSIONS
  PTK improved central corneal clarity, alleviated symptoms resulting from recurrent erosions, and improved visual acuity in both groups.
authors: Cornea Service, Wills Eye Institute, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors: Jagadesh C
authors: JC
authors: Reddy
authors: Christopher J
authors: CJ
authors: Rapuano
authors: Parveen K
authors: PK
authors: Nagra
authors: Kristin M
authors: KM
authors: Hammersmith
mesh_terms: D000328:Adult; D000368:Aged; D003315:Cornea / Q000503:physiopathology; D003317:Corneal Dystrophies, Hereditary / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016039:Corneal Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy; D012008:Recurrence; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult