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Ablation Depth-Dependent Survival Analysis of Phototherapeutic Keratectomy for Recurrent Corneal Erosion Syndrome
Kunal A Gadhvi1,2,3, Georgios Vakros3, Alfredo Borgia4,5
1Department of Corneal Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
Introduction:
Phototherapeutic keratectomy (PTK) is a treatment for recurrent corneal erosion syndrome (RCES). The aim of this study was to investigate whether deeper ablations yielded greater success rates.
Methods:
Retrospective case notes review with prospective patient-reported outcome measures for all patients who had undergone PTK for RCES at a single tertiary referral unit. Patients received treatment with the Schwind Amaris® 750 s excimer laser. The primary outcome measure was recurrence-free survival of patients with ablation depth ≥ 15 µm compared to < 15 µm.
Results:
Seventy eyes of 63 patients were included for analysis, of whom 39 (56%) had preceding trauma and 20 (29%) had epithelial basement membrane dystrophy (EBMD), with the remaining 11 (15%) of unknown aetiology. Twenty eyes (29%) received an ablation ≥ 15 µm (mean ablation depth 16.85 ± 3.4 µm) and 50 (71%) received < 15 µm (mean ablation depth 9.26 ± 1.5 µm). Overall, 65 eyes (93%) reported a subjective improvement in symptoms, with 46 (66%) remaining completely symptom free at the last follow-up [mean follow-up 24 (range, 9-48) months]. Eighty-five per cent of eyes in the ≥ 15 µm group remained symptom free compared to 58% of those with < 15 µm (p = 0.036).
Conclusion:
PTK is an effective treatment for RCES, with deeper ablations yielding longer symptom-free survival.
