Phototherapeutic Keratectomy for epithelial basement membrane dystrophy: long-term observation in Chinese patients

To evaluate the short-term and long-term efficacy of Phototherapeutic Keratectomy (PTK) in treating corneal epithelial basement membrane dystrophy (EBMD) and to investigate the factors that influence its outcomes.

This retrospective case series with prospective outcome evaluation analyzed all patients undergoing PTK for EBMD by a single surgeon at Eye & ENT hospital of Fudan University. Participants unresponsive to pharmacological therapy with recurrent ocular pain from epithelial erosions underwent PTK. Pre- and postoperative analysis included symptomatology, treatments, refractive status, visual acuity and corneal densitometry (CD).

Medical records of 40 patients aged 42.0 ± 13.5 years old were analyzed, with a follow-up duration ranging from 12 to 150 months. The mean ablation depth was 23.1 ± 9.7 μm, with a range of 6-40 μm. PTK significantly alleviated erosion symptoms and reduced the need for medication in both the short and long term postoperatively. A single erosive event was observed in one patient, but no patient warrant reoperation. Best Corrected Visual Acuity (BCVA) improved significantly after surgery, with 87.5% of patients achieving a BCVA of 20/20. No significant hyperopia or myopic shift was observed. CD values at center of the anterior and central strata decreased significantly after PTK (p < 0.05).

PTK with ablation depth of around 25 μm is a simple and feasible surgical method that effectively mitigates discomfort symptoms in patients with EBMD, minimizes medication reliance, and demonstrates safety and efficacy in long-term follow-up.