Phototherapeutic keratectomy in patients with recurrent corneal epithelial erosions

To evaluate the outcome of phototherapeutic keratectomy (PTK) in the management of recurrent corneal erosions, refractory to other forms of treatment.

Phototherapeutic keratectomy was performed on 43 eyes of 41 patients with recurrent corneal erosions. The corneal epithelium was debrided, and laser ablation was performed to a depth of 6 microm with an ablation zone of 7 to 9 mm, using the Technolas Keracor 117C PlanoScan excimer laser. Follow-up time was 12 to 48 months (mean, 23.3+/-9.1 mo).

After PTK, patients were free of symptoms in 31 eyes (72.1%), and eight eyes (18.6%) had occasional mild symptoms of irritation and photophobia upon awakening. Recurrence of painful corneal erosions occurred in four eyes (9.3%). After PTK retreatment, these patients did not report any further episodes and were free of symptoms for 12 to 30 months (mean, 21.0+/-7.7 mo). The mean spherical equivalent manifest refraction was changed by +0.15+/-0.39 D in the hyperopic direction at 1 year after PTK. Thirty-three eyes (76.7%) were within +/-1 line of preoperative best spectacle-corrected visual acuity (BSCVA). BSCVA was improved by two or more lines in 10 eyes (23.3%). There were no significant complications.

Excimer laser PTK with the Technolas Keracor 117C excimer laser was a safe and effective procedure for the treatment of recurrent corneal erosions. Excimer laser PTK can also be useful in improving the visual acuity in these patients. A small percentage of patients may require a second PTK to prevent further episodes of corneal erosions.