J Korean Ophthalmol Soc.  2011 Apr;52(4):392-400.

Clinical Results of Phototherapeutic Keratectomy for Refractory Recurrent Corneal Erosion

Affiliations
  • 1Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea. kopupil@hanmail.net

Abstract

PURPOSE
The present study evaluated the clinical results of phototherapeutic keratectomy (PTK) for refractory recurrent corneal erosion (RCE).
METHODS
A total of 12 eyes from 11 RCE patients who had been initially treated with conservative therapy but suffered from recurrence, were treated using PTK with 193 nm excimer laser. The preoperative and postoperative best corrected visual acuity (BCVA), spherical equivalent, average keratometric value, re-epithelialization time, corneal haze, complications and recurrence were investigated.
RESULTS
PTK was combined with photorefractive keratectomy in 1 eye. The mean follow-up time was 11.42 months. All 12 eyes were successfully treated and had no recurrence during the follow-up except 1 eye where the symptoms recurred 9 months postoperatively. Postoperative BCVAs were all better than the preoperative BCVAs. Mild myopic change (average -0.20 diopter) and increased average keratometric values (average 0.27 diopter) were noted in 11 eyes which were treated using PTK alone. The average re-epithelialization time was 5.63 days. No specific complication except mild corneal haze was found.
CONCLUSIONS
PTK is a safe and effective treatment for refractory RCE in short-term follow-up.

Keyword

Phototherapeutic keratectomy (PTK); Recurrent corneal erosion (RCE)

MeSH Terms

Eye
Follow-Up Studies
Humans
Lasers, Excimer
Photorefractive Keratectomy
Re-Epithelialization
Recurrence
Visual Acuity

Reference

References

1. Reidy JJ, Paulus MP, Gona S. Recurrent erosions of the cornea: epidemiology and treatment. Cornea. 2000; 19:767–71.
2. Lee SH, Kim TI, Chung SH, et al. A case of combined bacterial keratitis with recurrent corneal erosion. J Korean Ophthalmol Soc. 2007; 48:449–54.
3. Han MS, Lee JH, Lee SJ. Therapeutic effect of topical autologous serum in recurrent punctate corneal erosion. J Korean Ophthalmol Soc. 2004; 45:1639–44.
4. Suh Y, Kim MS. The longterm evaluation of recurrent corneal erosion. J Korean Ophthalmol Soc. 2002; 43:1570–6.
5. Benitez-Del-Castillo JM, Rodríguez-Bayo S, Fontan-Rivas E, et al. Treatment of recurrent corneal erosion with substance P-de-rived peptide and insulin-like growth factor I. Arch Ophthalmol. 2005; 123:1445–7.
Article
6. Dursun D, Kim MC, Solomon A, Pflugfelder SC. Treatment of re-calcitrant recurrent corneal erosions with inhibitors of matrix met-alloproteinase-9, doxycycline and corticosteroids. Am J Ophthalmol. 2001; 132:8–13.
Article
7. Wang L, Tsang H, Coroneo M. Treatment of recurrent corneal erosion syndrome using the combination of oral doxycycline and topical corticosteroid. Clin Experiment Ophthalmol. 2008; 36:8–12.
Article
8. Galbavy EJ, Mobilia EF, Kenyon KR. Recurrent corneal erosions. Int Ophthalmol Clin. 1984; 24:107–31.
Article
9. Trobe JD, Laibson PR. Dystrophic changes in the anterior cornea. Arch Ophthalmol. 1972; 87:378–82.
Article
10. Buxton JN, Constad WH. Superficial epithelial keratectomy in the treatment of epithelial basement membrane dystrophy. Ann Ophthalmol. 1987; 19:92–6.
Article
11. Hsu JK, Rubinfeld RS, Barry P, Jester JV. Anterior stromal puncture. Immunohistochemical studies in human corneas. Arch Ophthalmol. 1993; 111:1057–63.
12. Lee SW, Choi TH. Anterior stromal puncture with 26-gauge needle for recurrent corneal erosion: A report of five cases. J Korean Ophthalmol Soc. 2003; 44:511–6.
13. Soong HK, Farjo Q, Meyer RF, Sugar A. Diamond burr superficial keratectomy for recurrent corneal erosions. Br J Ophthalmol. 2002; 86:296–8.
Article
14. Wong VW, Chi SC, Lam DS. Diamond burr polishing for recurrent corneal erosions: results from a prospective randomized controlled trial. Cornea. 2009; 28:152–6.
Article
15. Hodkin MJ, Jackson MN. Amoils epithelial scrubber to treat recurrent corneal erosions. J Cataract Refract Surg. 2004; 30:1896–901.
Article
16. Trokel SL, Srinivasan R, Braren B. Excimer laser surgery of the cornea. Am J Ophthalmol. 1983; 96:710–5.
Article
17. Park JW, Kim JH. Phototherapeutic keratectomy for granular corneal dystrophy. J Korean Ophthalmol Soc. 2003; 44:2465–72.
18. Campos M, Nielsen S, Szerenyi K, et al. Clinical follow-up of phototherapeutic keratectomy for treatment of corneal opacities. Am J Ophthalmol. 1993; 115:433–40.
Article
19. Stark WJ, Chamon W, Kamp MT, et al. Clinical follow-up of 193-nm ArF excimer laser photokeratectomy. Ophthalmology. 1992; 99:805–12.
Article
20. Fagerholm P, Fitzsimmons TD, Orndahl M, et al. Phototherapeutic keratectomy: long-term results in 166 eyes. Refract Corneal Surg. 1993; 9:S76–81.
Article
21. Rapuano CJ, Laibson PR. Excimer laser phototherapeutic keratectomy for anterior corneal pathology. CLAO J. 1994; 20:253–7.
Article
22. Zuckerman SJ, Aquavella JV, Park SB. Analysis of the efficacy and safety of excimer laser PTK in the treatment of corneal disease. Cornea. 1996; 15:9–14.
Article
23. Rapuano CJ. Excimer laser phototherapeutic keratectomy: long-term results and practical considerations. Cornea. 1997; 16:151–7.
24. Förster W, Atzler U, Ratkay I, Busse H. Therapeutic use of the 193-nm excimer laser in corneal pathologies. Graefes Arch Clin Exp Ophthalmol. 1997; 235:296–305.
Article
25. Sher NA, Bowers RA, Zabel RW, et al. Clinical use of the 193-nm excimer laser in the treatment of corneal scars. Arch Ophthalmol. 1991; 109:491–8.
Article
26. Lawless MA, Cohen P, Rogers C. Phototherapeutic keratectomy for Reis-Bückler's dystrophy. Refract Corneal Surg. 1993; 9:S96–8.
Article
27. Lee SB, Lee JG, Hahn DK. A clinical experience of phototherapeutic keratectomy for Reis-Bucklers' dystrophy. J Korean Ophthalmol Soc. 1996; 37:365–70.
28. Lim MY, Sah WJ, Hahn TW, Kim JH. A Case of Reis-Buckler's dystrophy treated with excimer laser phototherapeutic keratectomy. J Korean Ophthalmol Soc. 1994; 35:1498–503.
29. Song SW, Kim MS. Phototherapeutic keratectomy for the treatment of persistent epithelial defect. J Korean Ophthalmol Soc. 1997; 38:1348–54.
30. Ko BY. Phototherapeutic keratectomy for refractory recurrent corneal erosion. Konyang Med J. 2008; 8:69–74.
31. Gipson IK, Spurr-Michaud SJ, Tisdale AS. Anchoring fibrils form a complex network in human and rabbit cornea. Invest Ophthalmol Vis Sci. 1987; 28:212–20.
32. Wood TO, Judge D, Payant J, Frase S. Electron microscopy of anterior stromal micropuncture. Invest Ophthalmol Vis Sci. 1989; 30:1.
33. Yoo JW, Chung JH, Lee HR. Effects of topically applied autologous serum on experimental corneal epithelial healing following alkali wounds. J Korean Ophthalmol Soc. 1998; 39:2003–12.
34. Khodadoust AA, Silverstein AM, Kenyon DR, Dowling JE. Adhesion of regenerating corneal epithelium. The role of basement membrane. Am J Ophthalmol. 1968; 65:339–48.
35. Nishida T, Nakagawa S, Manabe R. Clinical evaluation of fi-bronectin eyedrops on epithelial disorders after herpetic keratitis. Ophthalmology. 1985; 92:213–6.
Article
36. Nishida T, Yagi J, Fukuda M, et al. Spontaneous persistent epithelial defects after cataract surgery. Cornea. 1987; 6:32–7.
Article
37. Shapiro MS, Friend J, Thoft RA. Corneal re-epithelialization from the conjunctiva. Invest Ophthalmol Vis Sci. 1981; 21:135–42.
38. Lee SW, Choi TH. Anterior stromal puncture with 26-gauge needle for recurrent corneal erosion: A report of five cases. J Korean Ophthalmol Soc. 2003; 44:511–6.
39. McLean EN, MacRae SM, Rich LF. Recurrent erosion. Treatment by anterior stromal puncture. Ophthalmology. 1986; 93:784–8.
40. Geggel HS. Successful treatment of recurrent corneal erosion with Nd:YAG anterior stromal puncture. Am J Ophthalmol. 1990; 110:404–7.
Article
41. Katz HR, Snyder ME, Green WR, et al. Nd:YAG laser photo-in-duced adhesion of the corneal epithelium. Am J Ophthalmol. 1994; 118:612–22.
Article
42. Hwang JH, Im JS, Kim EK, Hong SB. Therapeutic effect of recurrent corneal erosion by Nd: YAG anterior stromal puncture. J Korean Ophthalmol Soc. 1998; 39:1319–25.
43. Ewald M, Hammersmith KM. Review of diagnosis and management of recurrent erosion syndrome. Curr Opin Ophthalmol. 2009; 20:287–91.
Article
44. Das S, Seitz B. Recurrent corneal erosion syndrome. Surv Ophthalmol. 2008; 53:3–15.
Article
45. Jain S, Austin DJ. Phototherapeutic keratectomy for treatment of recurrent corneal erosion. J Cataract Refract Surg. 1999; 25:1610–4.
Article
46. O'Brart DP, Muir MG, Marshall J. Phototherapeutic keratectomy for recurrent corneal erosions. Eye (Lond). 1994; 8:378–83.
47. Cavanaugh TB, Lind DM, Cutarelli PE, et al. Phototherapeutic keratectomy for recurrent erosion syndrome in anterior basement membrane dystrophy. Ophthalmology. 1999; 106:971–6.
48. Seitz B, Langenbucher A, Hafner A, et al. Phototherapeutic keratectomy for recurrent corneal erosion syndrome (e-PTK). Report on 116 consecutive interventions. Ophthalmologe. 2002; 99:703–8.
49. Morad Y, Haviv D, Zadok D, et al. Excimer laser phototherapeutic keratectomy for recurrent corneal erosion. J Cataract Refract Surg. 1998; 24:451–5.
Article
50. Dinh R, Rapuano CJ, Cohen EJ, Laibson PR. Recurrence of corneal dystrophy after excimer laser phototherapeutic keratectomy. Ophthalmology. 1999; 106:1490–7.
51. Baryla J, Pan YI, Hodge WG. Long-term efficacy of phototherapeutic keratectomy on recurrent corneal erosion syndrome. Cornea. 2006; 25:1150–2.
Article
52. Lohmann CP, Sachs H, Marshall J, Gabel VP. Excimer laser phototherapeutic keratectomy for recurrent erosions: a clinical study. Ophthalmic Surg Lasers. 1996; 27:768–72.
Article
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