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Published on: July 6, 2015
Phototherapeutic keratectomy in pediatric patients in India
Varsha Madanlal Rathi1, Sharadini Prateep Vyas, Pravin Krishna Vaddavalli
1Cornea and Refractive Surgery Services, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India. varsharathi@lvpei.org
Purpose:
To study the outcome of phototherapeutic keratectomy (PTK) in children younger than 16 years, with corneal scars, dystrophies, and band-shaped keratopathy.
Methods:
Records of 18 eyes of 14 patients younger than 16 years who had undergone PTK were retrospectively reviewed. Pre- and post-PTK visual acuity, corneal clarity, and need for additional surgery were noted. Flying spot and broad beam laser machines were used for PTK.
Results:
PTK was performed on 18 eyes of 14 patients; PTK was performed to treat scars (n = 8 eyes), band-shaped keratopathy (n = 5 eyes), and granular dystrophy (n = 5 eyes) for reduced vision. In addition, 1 patient had irritation, watering, and photophobia. All these patients had a clear visual axis after PTK. Refraction was possible only in 6 eyes before PTK; with increased clarity of the visual axis, it was possible in 15 patients after PTK. Before PTK, mean best-corrected logarithm of minimum angle of resolution visual acuity (Snellen equivalent) was 1.13 (20/250) and SD 0.92 (20/160); after PTK, it was 0.47 (20/60) and SD 0.37 (20/50) (P = 0.001). The primary disease recurred in 3 patients: granular dystrophy in 2 eyes, and scar along with Salzmann nodular degeneration in 1 eye. PTK was repeated in all 3 with good visual and symptomatic outcomes. None of these patients had infection or raised intraocular pressure.
Conclusions:
PTK is a safe and effective procedure in children. After PTK, corneal clarity is enhanced, facilitating accurate refraction and leading to improved visual acuity in most eyes. PTK can be safely repeated in case of recurrence.
