Phototherapeutic keratectomy: strategies and results in 12 eyes

As part of a multicenter study of excimer laser procedures, we performed phototherapeutic keratectomy (PTK) on 12 eyes in 11 patients. Three eyes had superficial corneal scarring, two Salzmann's degeneration, two Reis-Bückler's dystrophy; and one each with recurrent lattice dystrophy in a corneal graft, band keratopathy, recurrent erosion syndrome, after pterygium scarring, and contact-lens related keratopathy. Indications for treatment included poor visual acuity, severe glare symptoms, ocular surface discomfort, recurrent erosions, and monocular diplopia. Follow up ranged from 1 to 4 months. Best spectacle corrected visual acuity improved in ten eyes with no eyes suffering loss of best spectacle corrected visual acuity. A hyperopic refractive shift was found in eight of 12 treated eyes. Corneal surface regularity improved in six of 12 eyes and worsened in one eye as measured by computerized corneal topographic analysis. Ten patients (11 eyes) noted improvement in their visual perception and subjective symptoms. We review various strategies of phototherapeutic keratectomy designed to treat particular corneal disorders: patient selection criteria to optimize clinical outcome are reviewed as well.