[Phototherapeutic keratectomy (PTK) after epidemic keratoconjunctivitis]

Persistent and recurrent nummuli after epidemic keratokonjunktivitis (EKC) often lead to reduced visual acuity and increased glare. In spite of long-term topical steroid therapy nummuli often recur. We tried to treat persistent nummuli with phototherapeutic keratectomy (PTK).

PTK with an excimer laser (193 nm) was performed in 13 eyes of 9 patients with nummuli. The nummuli were observed over 3-72 months (mean: 36 months). Preoperatively, the visual acuity was 0.1-0.9 (mean: 0.39 +/- 0.22) and the brightness acuity test (BAT) was 0.05-0.5 (mean: 0.25 +/- 0.15). Prior to PTK all eyes had been treated with local steroids several times for recurrent nummuli.

During the follow-up from 15 to 56 months (mean: 33 +/- 11.5 ms), 11 eyes had an increase in visual acuity: 0.3-1.0 (mean: 0.63 +/- 0.26). The reduction of glare was especially beneficial for the patients: 0.3-0.9 (mean: 0.55 +/- 0.21). One patient had a recurrence of nummuli in both eyes 6 weeks after PTK. The subjective-induced spheric refractive change was -2.5 D to +2.0 D. The astigmatic error changed between -2.0 D to +1.5 D.

PTK seems to be an effective method of treating persistent, recurrent nummuli after EKC. The low rate of recurrence of nummuli after PTK is remarkable.