Phototherapeutic keratectomy in nine eyes with superficial corneal diseases

We performed phototherapeutic keratectomy (PTK) in seven patients (nine eyes) with superficial corneal disease such as band keratopathy (one patient), Reis-Bückler's dystrophy (one patient, two eyes), granular dystrophy (two patients, three eyes), recurrent granular dystrophy (one patient), postinfection scar (one patient), and corneal scarring after pterygium removal (one patient). All patients received PTK after topical anesthesia with Pontocaine 0.5% and underwent epithelial removal with a surgical blade. We used methylcellulose 1.0% as a surface modulator before laser ablation. Focal ablation of the central cornea with an ablation zone of 5 mm was performed routinely in most eyes and a smoothing technique was applied only in two eyes. All patients were followed for more than 9 months. Uncorrected and corrected visual acuity were significantly improved in six patients (8 eyes) and a mild hyperopic shift occurred in all eyes that received PTK centrally. Mild to moderate corneal haze appeared in these corneas during the first few months after surgery. Some patients avoided the need for keratoplasty. No significant complications occurred after PTK except recurrence of granular deposits in one case of granular dystrophy. We think that PTK with the 193-nanometer excimer laser is indicated in the treatment of some superficial corneal disorders.