title: Long-term outcomes of optical coherence tomography-guided transepithelial phototherapeutic keratectomy for the treatment of anterior corneal scarring.
abstract: OBJECTIVE
  To report the long-term outcomes of optical coherence tomography (OCT)-guided transepithelial phototherapeutic keratectomy (PTK) for the management of anterior corneal scarring.
  
  
  METHODS
  The charts of 60 patients (64 eyes) who underwent OCT-guided transepithelial PTK for anterior corneal scarring were retrospectively reviewed. The procedure involved a preoperative OCT-measured depth of treatment calculation to reduce or eliminate corneal scarring, followed by a combined myopic and hyperopic transepithelial excimer laser treatment profile established to attain the desired refractive result. The main outcome measures consisted of change in best spectacle-corrected visual acuity (BSCVA), change in OCT-measured parameters, and change in corneal topography indices.
  
  
  RESULTS
  The mean follow-up was 41.0 weeks (range: 12-117 weeks). BSCVA improved from a mean of 0.77 logMAR (0.65-0.89) preoperatively to a mean of 0.34 logMAR (0.21-0.46) postoperatively (p<0.0001). Comparison of preoperative and postoperative corneal topographic indices showed significant improvement in all parameters analysed: corneal cylinder (p=0.0008), surface asymmetry index (p=0.0054), surface regularity index (p=0.0047) and projected visual acuity (p=0.0045). Postoperative spherical equivalent averaged 0.91 (±0.71) dioptres of error from the intended target refractive outcome. Two patients required penetrating keratoplasty and one patient underwent repeat PTK during the study interval.
  
  
  CONCLUSIONS
  The OCT-guided transepithelial PTK technique described in this study can deliver positive long-term results and predictable refractive outcomes in the treatment of anterior corneal scarring.
authors.affiliation: Panhandle Eye Group, Amarillo, Texas, USA Texas Tech University Health Science Center, Amarillo, Texas, USA.
authors.forename: Sloan W
authors.initials: SW
authors.lastname: Rush
authors.affiliation: Texas Tech University Health Science Center, Amarillo, Texas, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Matulich
authors.affiliation: Panhandle Eye Group, Amarillo, Texas, USA Texas Tech University Health Science Center, Amarillo, Texas, USA Southwest Retina Specialists, Amarillo, Texas, USA.
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Rush
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003316:Corneal Diseases / Q000175:diagnosis / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000379:methods*; D011182:Postoperative Care; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
keywords: Cornea; Imaging