Surgical outcomes of re-excimer laser phototherapeutic keratectomy (re-PTK)

Abstract

To assess the surgical outcomes of re-excimer laser phototherapeutic keratectomy (re-PTK) for recurrent disease after initial PTK. Retrospective cohort study with historical comparison group. This study involved 56 patients who underwent re-PTK (mean follow-up period: 47.9 ± 36.2 months) at the Baptist Eye Institute, Kyoto, Japan. In all subjects, corrected-distance visual acuity (CDVA) before and after re-PTK was compared. Postoperative recurrence of corneal lesion with a decrease of CDVA of two lines or more was compared with postoperative best CDVA deemed as a significant relapse. The Kaplan–Meier method was used to compare the recurrence rate post-re-PTK with that after the initial PTK. The disease classification in the 78 eyes was heterozygous-type GCD (hetero-GCD, n = 47 eyes), homozygous-type GCD (homo-GCD, n = 13 eyes), band keratopathy (n = 7 eyes), lattice corneal dystrophy (n = 6 eyes), and other (n = 5 eyes). After re-PTK, homo-GCD recurred statistically significantly earlier than hetero-GCD (P = 0.0042). No significant difference was found in the recurrence rate for all diseases between post-re-PTK and post initial PTK (P > 0.05). Surgical outcomes after re-PTK were nearly equal to those after initial-PTK.

Late recurrence of corneal dystrophy treated with phototherapeutic keratectomy combined with epikeratophakia using double lenticules

“…15 A study by Hieda et al reported no significant differences in recurrence rates between first PTK treatment and repeated PTK in patients with variant types of corneal dystrophy. 16 There are no studies on the recurrence interval after PTK + EP in corneal dystrophy; in this case, however, RBCD recurred 4 years after the first PTK and again 5.5 years after the PTK + EP procedure, suggesting that PTK + EP exhibits a recurrence time comparable with that of PTK and is effective in delaying the need for corneal transplantation. In addition, Olson et al and Caldwell et al reported 2 cases of RBCD recurring in the graft 10 years after undergoing penetrating corneal transplantation, and Salouti et al concluded that prior PTK is a risk factor of corneal dystrophy recurrence after corneal transplantation.…”