No abstract

A series of 122 eyes with band keratopathy was treated by excimer laser phototherapeutic keratectomy (PTK), with a mean foliow up of over 12*3 months (range 3 to 60 months). A single photoablation zone was used to remove the opacity over the visual axis in smooth surfaced band deposition. In eyes with reduced vision, an improvement was reported in 88% and in a series of 66 eyes mean Snelien visual acuity increased significantly (p<005, t=2-27). A reduction in glare was reported in 88% and in a series of 17 patients, visual contrast sensitivity (p<001) and measurements of disability glare (p<001) improved postoperatively. The mean hyperopic shift in 32 eyes at 6 months was 1.4 D (range 0-4-25 D).Multiple overlapping ablation zones, with mechanical debulking of large calcium plaques, were used to smooth the irregular corneal surface in eyes with rough bands. Ocular discomfort was improved in 95%. Band keratopathy recurred in nine eyes (8%) within 2 to 30 months (mean 12 months) of surgery, with silicone oil responsible in five eyes. Reablation was necessary in three eyes and performed successfuliy in all cases. Excimer laser PTK is a safe and effective outpatient treatment for band keratopathy. (BrJ Ophthalmol 1993; 77: 702-708)

No abstract

Recurrent corneal erosion may be a difficult disorder to treat, with a number of patients suffering persistent symptoms despite conventional therapy. We present a series of 15 patients (17 eyes) who underwent excimer laser phototherapeutic keratectomy (PTK) for recurrent corneal erosion. In 9 patients a previous episode of corneal trauma could be identified, while in 6 (8 eyes) the problem had occurred spontaneously. The mean duration of symptoms prior to PTK was 13 months (range 6-60 months). All patients had received lubricant ointments, 7 had tried bandage contact lenses and 4 had undergone epithelial debridement with no amelioration of their symptoms. The affect area of epithelium was removed and a 20-30 pulse (5-7 microns) ablation was performed to Bowman's membrane. Great care was taken to avoid the edges of treatment zones from encroaching on the axial cornea. In 11 patients (13 eyes) there was a marked improvement in symptoms post-operatively with no recurrences. The mean follow-up was 11 months (range 6-24 months). Four patients experienced recurrent episodes 3-6 months after PTK and 2 have subsequently been retreated, 1 of whom has been symptom-free for 12 months. Post-operative best corrected visual acuity was unaltered in 9 eyes and improved by at least one Snellen line in 8 eyes. Excimer laser PTK appears to be a safe and promising procedure for recurrent corneal erosion in cases refractory to medical treatment. Further studies are indicated to compare its effectiveness with established surgical procedures.

No abstract