Indications and outcomes of phototherapeutic keratectomy in the developing world.

PURPOSE

To analyze the indications and outcomes of phototherapeutic keratectomy (PTK) in the developing world.

METHODS

In this retrospective study, the records of 203 consecutive eyes of 191 patients who had undergone PTK at a tertiary eye care center were evaluated. The parameters assessed were indications of PTK, demographic features, best spectacle-corrected visual acuity (BSCVA), and pachymetry. PTK was done by using a 193-nm Ar-F Excimer laser (Chiron Technolas Keracor 217 C) in a 6-mm optic zone. Patients were followed up for 6 months.

RESULTS

The most common indication of PTK was symptomatic bullous keratopathy (103 eyes). The patients were divided into 2 groups: those with bullous keratopathy (PTK BK) and those with superficial corneal pathologies (PTK CS). In the PTK CS group, the most common indications were Salzmann nodular degeneration (n = 27) and spheroidal degeneration (n = 22). BSCVA improved from 20/222 (0.09) to 20/86 (0.23) in the PTK CS group and 20/384 (0.05) to 20/202 (0.09) in the PTK BK group (P < 0.0001 in both groups). There was a significant decrease in the number of patients with severe symptoms in the PTK-BK (P < 0.0001) and PTK-CS (P = 0.017) groups. The change in BSCVA was significantly related to both pre-PTK BSCVA and pachymetry in PTK-BK.

CONCLUSIONS

PTK is an efficacious treatment modality for symptomatic relief and visual gain in cases with superficial corneal involvement and bullous keratopathy.