Excimer laser phototherapeutic keratectomy in eyes with corneal stromal dystrophies with and without a corneal graft.

Abstract

PURPOSE:

To evaluate and compare the visual outcomes and recurrence patterns of corneal stromal dystrophies after excimer laser phototherapeutic keratectomy (PTK) in eyes with and without a corneal graft.

DESIGN:

Retrospective, comparative case series.

METHODS:

setting: Cornea Service, Wills Eye Institute, Philadelphia Pennsylvania. study population: The patients were divided into 2 groups. Group 1 comprised patients with no graft who underwent PTK (22 eyes of 15 patients), and group 2 comprised patients who underwent PTK over a previous full-thickness graft (18 eyes of 14 patients). intervention: All patients underwent PTK for decreased vision, symptoms of recurrent erosions, or both. main outcome measures: Visual outcomes and recurrence patterns of corneal stromal dystrophies.

RESULTS:

Preoperative and postoperative best-corrected visual acuities were 0.46 ± 0.25 and 0.51 ± 0.27 (P = .56), respectively, in group 1 and 0.16 ± 0.13 and 0.21 ± 0.18 (P = .25), respectively, in group 2. Mean preoperative spherical equivalent was 1.54 ± 2.59 diopters (D) and -5.10 ± 5.81 D (P = .01) in groups 1 and 2, respectively, and mean postoperative spherical equivalent was 0.44 ± 1.8 D and -1.8 ± 4.25 D (P = .19) in groups 1 and 2, respectively. There was no statistically significant difference in the efficacy (P = .73) and safety (P = .62) indices between the 2 groups. In group 1, mild recurrence was seen in 7 eyes (32%) and significant recurrence was seen in 4 eyes (18%) at a mean of 32 and 47 months after PTK, respectively. In group 2, mild recurrence was seen in 5 eyes (28%) and significant recurrence was seen in 5 eyes (28%) at a mean of 36 and 50 months after PTK, respectively.

CONCLUSIONS:

PTK improved central corneal clarity, alleviated symptoms resulting from recurrent erosions, and improved visual acuity in both groups.

• Authors: Jagadesh C Reddy, Christopher J Rapuano, Parveen K Nagra, Kristin M Hammersmith
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 155 Issue 6 Pg. 1111-1118.e2 (Jun 2013) ISSN: 1879-1891 [Electronic] United States
• PMID: 23434207 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Cornea (physiopathology)
• Corneal Dystrophies, Hereditary (diagnosis, physiopathology, surgery)
• Corneal Transplantation
• Female
• Follow-Up Studies
• Humans
• Lasers, Excimer (therapeutic use)
• Male
• Middle Aged
• Photorefractive Keratectomy
• Recurrence
• Retrospective Studies
• Visual Acuity (physiology)
• Young Adult