Efficacy of phototherapeutic keratectomy in various superficial corneal pathologies

To study the use of phototherapeutic keratectomy in the treatment of various corneal pathologies.

We performed a nonrandomized consecutive study of patients who presented with superficial corneal diseases and poor vision. After slit-lamp microscopy, 31 eyes were included: corneal dystrophies, 20 eyes; pterygium, 1 eye; recurrent erosions, 3 eyes; superficial corneal opacities, 6 eyes; band-shaped keratopathy, 1 eye. All patients were treated with the Nidek EC-5000 excimer laser following manual epithelial debridement. A central 6.0 to 7.5-mm zone was treated with a surrounding 1-mm blend zone. Ablation zone diameter was determined by surgeon preference, presence of pannus, and overall corneal diameter. Follow-up ranged from 6 to 24 months, with a mean of 1 year.

Epithelial healing occurred between 3 and 8 days in most eyes. Patients were followed for a minimum of 1 year. More than 50% of patients gained more than 2 Snellen lines; 12% for whom PTK was done for recurrent corneal erosions were symptomatically better. No eye was retreated. One patient with band keratopathy did not improve. Delayed epithelial healing occurred in three eyes. A trace to mild reticular subepithelial stromal haze was present in most eyes. Most patients showed a tendency to shift toward hyperopia.

Phototherapeutic keratectomy may facilitate better visual acuity and reduced photophobia in eyes with various corneal pathology. Proper case selection is crucial.