Phototherapeutic keratectomy: who are the best candidates and how do you treat them?

PURPOSE OF REVIEW

To discuss the primary types of lesions most amenable to excimer laser phototherapeutic keratectomy (PTK) and the specific techniques to best treat each of these disorders.

RECENT FINDINGS

Elevated and anterior stromal lesions respond best to PTK. PTK can also be used to effectively treat recurrent erosions. Smoothing agents and intraoperative mitomycin C can be helpful for certain disorders.

SUMMARY

The preoperative evaluation is very important in order to establish whether the eye is a good candidate for excimer laser PTK. Careful slit lamp evaluation and ancillary testing can not only determine how good a candidate they are but just as importantly, the best surgical approach. Surgeons and patients need to understand the limitations of PTK for proper informed consent. PTK is a minimally invasive procedure that is often successful in delaying or avoiding more aggressive corneal surgeries.