Ten-year results of phototherapeutic keratectomy on recurrent corneal erosions.

PURPOSE

To determine the ten-year visual results and outcomes of excimer laser phototherapeutic keratectomy (PTK) for recurrent corneal erosions.

METHODS

Twenty-six eyes of 23 patients with recurrent corneal erosions were treated by PTK from 1996 to 2000 at the Goiania Eye Institute, Brazil. All eyes had failed to respond to conventional therapy. Data regarding preoperative and postoperative best-spectacle-corrected visual acuity (BSCVA), spherical equivalent (SE), symptomatic relief, incidence of recurrence, and complications arising from the laser treatment were analyzed. The mean duration of symptoms prior to PTK was 18 months (range, 8 to 36 months). The corneal epithelium was debrided, and laser ablation was performed to a depth of 5 micron with an ablation zone of 7 to 9 mm, using the Technolas 217C Plano Scan excimer laser. Mean postoperative follow-up was 12 years (range, 10 to 14 years).

RESULTS

At the last follow-up visit, 15 eyes (57.69%) were symptomsfree. Five eyes (19.2%) had occasional mild symptoms of irritation and photophobia upon awakening. Recurrence of painful corneal erosions occurred in six eyes (23.07%), which required a PTK retreatment. Twenty-four eyes had a preserved or improved BCVA, while 2 eyes showed deterioration of 1 line on Snellen test. Eleven eyes (42.3%) had no change in SE, and the others (57.69%) had a change of less than +/-0.75 diopters (D). There were no major complications during the follow-up period.

CONCLUSION

Ten-year data show that PTK is a safe, fast, effective and minimal invasive choice of treatment for recurrent corneal erosions in patients who do not respond to conventional treatments.