97th DOG Annual Meeting 1999
PHOTOTHERAPEUTIC KERATECTOMY FOR TREATMENT OF RECURRENT EROSIONS
B. Schloßmacher, G. Pötzsch, C. Redbrake
Background: Treatment of recurrent erosion is often unsuccessful. In intervals without symptoms, at least conservative treatment has to be continued. Corneal stiching and mechanical abrasio show a high frequency of recurrence. Phototherapeutic keratectomy is a new way of treating these cases. But up to now, long-term results are missing.
Patients: 21 patients with recurrent erosion aged from 26 to 72 years (mean: 42 years) were followed up for 2 to 56 months (mean: 27 months). All patients had previously been treated conservatively and/ or surgically. The duration of disease ranged from 4 months to 23 years (mean: 5,8 years). In mean, 5 episodes of recurrence were observed. 8 patients underwent PTK without mechanical abrasio. Depth of ablation ranged between 6 and 16 µm.
Results: 16 patients were free of any recurrence during the observation period. In 5 patients a recurrence was observed. Three of them were treated again by PTK. In these three cases also no recurrence was observed. Altogether, the rate of recurrence was 3.9%. There was no difference in recurrence in those patients who were treated with and without abrasio.
All recurrences were observed in patients with a depth of ablation beyond 8 µm. Depth of ablation over 18 µm did not lead to changes in refraction and visual acuity.
Conclusion: The rate of recurrence in this study is rather low compared to those in other PTK studies. Other surgical procedures like stiching, abrasio and ND-Yag showed much higher rates of recurrence. Therefore we conclude that PTK is a safe and very successful treatment of recurrent erosion.
RWTH Aachen, Department of Ophthalmology