Phototherapeutic keratectomy for treatment of recurrent corneal erosion

Jain, Sunila; Austin, David

doi:10.1016/s0886-3350(99)00262-x

Cited by 49 publications

(48 citation statements)

References 13 publications

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“…10 In a number of studies, however, recurrent erosions were reported following partial ablation of BL by PTK, 7-9,15-17 and resolution of symptoms only after re-treatment. 9,15,17 We noted in our study almost half of the operated eyes had signs of recurrence in some form.…”

Section: Discussionsupporting

confidence: 57%

“…The original indication for operation in this study was RCE in only 50% of the cases, whereas in a number of earlier reports, the majority of EBMD patients had RCE symptoms. [7][8][9][10][12][13][14][15][16][17] In one report, however, 67% of 30 EBMD eyes treated by PTK did not have RCE, 6 and in another series of 74 EBMD eyes, 82% were without RCE. 25 It is important to recognize that EBMD is a condition that can lead to visual disturbances, RCE, or both.…”

Section: Discussionmentioning

confidence: 99%

“…Poor visual outcome (a form of clinical recurrence) in some EBMD patients has been noted after PTK 10,17 with one study using a shallow ablation of 6m 17 while the actual ablation depth was not given in the other study. 10 In a number of studies, however, recurrent erosions were reported following partial ablation of BL by PTK, 7-9,15-17 and resolution of symptoms only after re-treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, excimer laser phototherapeutic keratectomy (PTK) has become an increasingly popular surgical option for the treatment of EBMD, due to successful resolution of symptoms documented in a number of studies. [4][5][6][7][8][9][10][11][12][13][14] While the majority of PTK treatments are successful, postoperative recurrence of symptoms has been reported, [6][7][8][9][10][15][16][17] and the reasons for recurrence remain unclear. In a recent study examining a small number of EBMD patients longitudinally, we proposed that dystrophic recurrence may be related to the depth of laser ablation by PTK and the postoperative presence of Bowman's layer (BL).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcome and Recurrence of Epithelial Basement Membrane Dystrophy after Phototherapeutic Keratectomy

2011

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcome and Recurrence of Epithelial Basement Membrane Dystrophy after Phototherapeutic Keratectomy

2011

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“…A minority of patients may require bandage contact lenses during the postoperative follow-up. 70 PTK is an effective treatment for RCE, with a success rate between 60 and 100%. 67,71 This variability in success rate may be due to the initial indication for PTK in the various studies carried out.…”

Section: Anterior Stromal Puncturementioning

confidence: 99%

Pathogenesis, clinical features and management of recurrent corneal erosions

Ramamurthi

Rahman

Dutton

et al. 2005

Eye

109

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Recurrent corneal erosions (RCE) are common. They are characterised by repeated episodes of pain, difficulty in opening the eyes, watering, and photophobia resulting from poor epithelial adhesion. In the majority of patients with RCE, trauma is the initiating factor. Epithelial, stromal, and endothelial corneal dystrophies have all been described in association with RCE. Other causes that may lead to RCE include chemical and thermal injuries, previous herpetic keratitis, meibomian gland dysfunction, ocular rosacea, diabetes mellitus, Salzmann's nodular degeneration, band keratopathy, previous bacterial ulceration, kerato-conjunctivitis sicca, and epidermolysis bullosa. The conditions that are associated with RCE can be either primary or secondary depending on whether the basement membrane complex abnormality is intrinsic or acquired. Primary types tend to be bilateral, symmetrical and develop in multiple corneal locations. The pathogenetic mechanism of this disorder is related to poor adhesion of the corneal epithelium to the underlying stroma. Excessive matrix metalloproteinase (MMP) activity may play a role in the pathogenesis. Although the majority of patients will respond to simple measures such as padding and antibiotic ointment, RCE resistant to simple measures require approaches that are more elaborate. The common goal of these approaches is to encourage proper formation of adhesion complexes between the epithelium and the stroma. The use of longterm contact lenses, autologous serum eye drops, botulinum toxin, induced ptosis, oral MMP inhibitors, diamond burr polishing of Bowman's membrane have been reported with varying degree of success in treating RCE. Anterior stromal puncture with insulin needles or Neodymium : aluminium-yttriumgarnet may enhance the epithelial adhesion to the basement membrane by scar formation and success rates of up to 80% have been reported in the treatment of recalcitrant RCE. Excimer laser photo-therapeutic keratectomy (PTK) is now a well-established treatment modality for RCE and is being used both safely and effectively. Partial ablation of Bowman's layer with PTK gives a smooth surface for the newly generating epithelium to migrate and form adhesion complexes. The pathogenesis, clinical features, and management options of this common disorder are discussed in this review article.

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Phototherapeutic Keratectomy for Anterior Basement Membrane Dystrophy After Laser In Situ Keratomileusis

Rojas

Manche²

2002

Arch Ophthalmol

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To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) in the treatment of symptomatic anterior basement membrane dystrophy following laser in situ keratomileusis (LASIK). Methods: In a retrospective study, 10 eyes of 10 patients that developed symptomatic anterior basement membrane dystrophy following LASIK for myopia were treated with PTK using the VISX S2 (VISX Inc, Santa Clara, Calif) excimer laser. Primary outcome measurements including corneal clarity, resolution of symptoms, uncorrected visual acuity (UCVA), manifest refraction, best spectacle-corrected visual acuity (BSCVA), and complications were evaluated preoperatively, 1 day postoperatively, and at the last postoperative follow-up visit. Results: At the last follow-up visit (mean [SD], 8.8 [5.5] months; range, 4-22 months), 100% of the eyes had clear corneas with no evidence of anterior basement membrane dystrophy, and all eyes were asymptomatic. Mean spherical equivalent changed from −0.75 (0.99) diop-(REPRINTED) ARCH OPHTHALMOL / VOL 120, JUNE 2002 WWW.ARCHOPHTHALMOL.COM

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Phototherapeutic keratectomy for treatment of recurrent corneal erosion

Abstract: Phototherapeutic keratectomy is a safe and effective treatment for refractory RCE and, where appropriate, can be combined with PRK.

Cited by 49 publications

References 13 publications

Clinical Outcome and Recurrence of Epithelial Basement Membrane Dystrophy after Phototherapeutic Keratectomy

Clinical Outcome and Recurrence of Epithelial Basement Membrane Dystrophy after Phototherapeutic Keratectomy

Pathogenesis, clinical features and management of recurrent corneal erosions

Phototherapeutic Keratectomy for Anterior Basement Membrane Dystrophy After Laser In Situ Keratomileusis

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