[Phototherapeutic keratectomy. Undesirable effects, complications, and preventive strategies]

The conceptual advantage of phototherapeutic keratectomy (PTK) include the option to remove diseased tissue on a micrometer scale. Although less invasive than other forms of corneal surgery, it remains a surgical procedure which carries inherent risks. In phototherapeutic indications this risk is higher than in otherwise healthy eyes undergoing photorefractive surgery. Potential general complications include wound-healing problems, infection, inflammation, or a recurrence of the underlying disease. More specifically, PTK is associated with unwanted refractive changes, such as a hyperopic shift or an irregular astigmatism. In this review, we discuss these problems along with prevention and treatment strategies in detail.