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Excimer laser phototherapeutic keratectomy
M Starr1, E Donnenfeld, M Newton
1Phototherapeutic Keratectomy Section, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA.
Cornea
|November 1, 1996
Summary
Excimer laser phototherapeutic keratectomy (PTK) improved vision and reduced eye irritation for anterior corneal conditions. While effective, potential complications like refractive changes and increased eye pressure require careful consideration.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Laser Vision Correction
Background:
- Excimer laser phototherapeutic keratectomy (PTK) is used for anterior corneal pathology.
- Previous studies often involved small patient numbers and limited follow-up.
- This study presents one of the largest PTK series with extended follow-up.
Purpose of the Study:
- To evaluate the safety and efficacy of excimer laser PTK for anterior corneal conditions.
- To assess visual acuity and refractive outcomes post-PTK.
- To document complications associated with PTK.
Main Methods:
- Forty-five patients with anterior corneal pathology underwent PTK using the Visx Excimer Laser System.
- Conditions treated included scars, dystrophies, degenerations, pterygia, and epithelial basement membrane dystrophies.
- Follow-up averaged 11.25 months, with 40 patients observed for at least 6 months.
Main Results:
- Significant improvement in irritative symptoms and visual acuity was observed.
- Best spectacle corrected visual acuity (BSCVA) improved, with 60% achieving 20/50 or better post-procedure.
- Refractive changes were unpredictable, including a mean hyperopic shift and induced astigmatism. Complications occurred in six patients.
Conclusions:
- Excimer laser PTK offers modest to substantial improvement in symptoms and visual acuity for anterior corneal pathology.
- Potential adverse effects, though present, appear less severe than alternative treatments like keratoplasty.
- PTK is a viable option, but refractive unpredictability and potential complications necessitate careful patient selection and management.