Treatment of band keratopathy by excimer laser phototherapeutic keratectomy: surgical techniques and long term follow up.

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)

Therapeutic use of the 193-nm excimer laser in corneal pathologies

“…The observed recurrence rate was low even if the drop-out patients were included as recurrences. This fits well with other reports [28]. It seems obvious that the surgical technique has a minor influence on the recurrence rate.…”

Management of band keratopathy with excimer phototherapeutic keratectomy: visual, refractive, and symptomatic outcome

“…While the majority of bands will respond, deposition of noncalcific material may limit the effectiveness of such treatment, 10 and manual keratectomy may cause postoperative surface irregularities. However, the merit of PTK compared to EDTA chelation for band keratopathy requires a prospective controlled trial before conclusions regarding the relative outcome of these treatment modalities can be made.…”

“…9 Noncalcific material deposition may account for the poor response to chelating agents such as EDTA seen in some eyes. 10 The indiscriminate ablative action of PTK means that treatment of all bands, independent of biochemical make-up, is possible. Excimer ablation allows precise tissue removal over wide areas of cornea without trauma to adjacent tissue, resulting in smooth ablation zones.…”

Synthesis of calcium–silica composites: A route toward an in vitro model system for calcific band keratopathy precipitates

“…These treatment options are less than satisfactory as they are frequently associated with significant post treatment pain, discomfort, and a delay in visual recovery. 14 In addition,…”