Phototherapeutic keratectomy for treatment of recurrent corneal erosion

Abstract

PURPOSE: To study the role of phototherapeutic keratectomy (PTK) in the management of recurrent corneal erosion (RCE) refractory to other forms of treatment. SETTING: The Eye Department of Leicester Royal Infirmary, a tertiary referral center, Leicester, England. METHOD: A retrospective analysis of all patients who had PTK for refractory RCE between July 1994 and October 1998 was performed. The patients were recalled to determine whether they had further symptoms and whether there had been a change in their refractive error or their best corrected visual acuity. RESULTS: Seventy-seven eyes of 68 patients were treated and divided into 3 etiologic groups: trauma, 40 eyes; corneal dystrophy, 24 eyes; and no established cause (idiopathic), 13 eyes. Phototherapeutic keratectomy was combined with photorefractive keratectomy (PRK) in 6 eyes with a good result. A single treatment was performed in 71 eyes (92.2%). No significant refractive change occurred in 67.5% of eyes; 22.1% developed hyperopia (range 0 to +2.0 diopters [D]), and 10.3% developed myopia (range 0 to -1.5 D). Best corrected visual acuity was unchanged in 72.7% of eyes; 11.7% lost 1 Snellen line and 15.5% gained 1 line. There were no symptoms in 68.8% of eyes; in 31.2%, minor symptoms were noted in the morning, and these patients continued to use ocular lubricants at night. CONCLUSION: Phototherapeutic keratectomy is a safe and effective treatment for refractory RCE and, where appropriate, can be combined with PRK.