Excimer laser phototherapeutic keratectomy:Treatment modalities and results in 34 eyes

Purpose. As part of an FDA sponsored multicenter study using the 193nm excimer laser, an investigation was undertaken to assess the treatment techniques and efficacy of performing phototherapeutic keratectomy (PTK) for superficial surface irregularities, scars and recurrent epithelial erosions. Methods. 34 eyes of 31 patients underwent PTK. Preoperative diagnoses included Reis-Bucklers' and lattice dystrophies, Saltzmann's degeneration, band keratopathy, superficial corneal scarring and recurrent erosion syndrome. A standardized treatment protocol was used. Follow-up averaged 9 months. Visual acuity, refraction, corneal pachymetry and topography, wound healing and subjective symptomology were assessed preoperatively and postoperatively.. Depending upon the underlying corneal condition, each eye underwent etiher PTK alone or PTK combined with mechanical superficial keratectomy. Results. Best corrected vision improved in 26/34 eyes. A clinically significant hyperopic shift was found in 19/34 eyes. Corneal surface regularity improved in 21/34 eyes, was unchanged in 10/34 eyes and worsened in 1 eye. Subjective symptomology improved in 31/34 eyes. Conclusions. Excimer laser PTK may serve as an adjunctive modality in the treatment of appropriately selected disorders of the superficial cornea.