This article is more than 5 years old. Information may no longer be current.

PTK useful for treating LASIK striae

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

SAN FRANCISCO — In patients with microstriae after LASIK, phototherapeutic keratectomy may be useful in smoothing out the corneal surface, according to one surgeon.

Roger Steinert, MD, speaking during a panel discussion here at the VisionQuest 2002 meeting, said he has found phototherapeutic keratectomy (PTK) more helpful in managing post-LASIK striae than some other methods, most notably irrigation or stretching.

In PTK for post-LASIK striae, he uses a broad beam laser like the Summit or the Visx Star S3. He performs transepithelial PTK, continuing until the epithelium begins to disappear. Dr. Steinert said this landmark is visible when he uses the Summit laser, but he stops after 200 pulses with the Visx Star S3 laser "because it is extremely hard to see the fluorescence disappear.”

According to Dr. Steinert, after about 200 pulses some surface irregularities may still be visible.

“Sometimes it actually looks worse rather than better,” he warned. After checking the site, he adds medium viscosity artificial tears using a moderately moistened Merocel sponge. Additional pulses are then applied up to an “absolute maximum” of 300, he said.

“As soon as it starts to look smooth, stop,” Dr. Steinert said. “You don’t want to overdo this.”

In the first 19 eyes Dr. Steinert treated using this technique, he noted a marked improvement in best corrected visual acuity. Twelve patients were treated following primary LASIK and seven were treated after an enhancement.

“If you look at lines of improvement, only one eye got worse. That was someone who had a complicated flap situation where we were kind of pushing the limit,” he said. Most eyes treated had no discernable haze and only three eyes had a haze of 1+. A hyperopic shift of less than 1 D was also seen.

“[The hyperopic shift] and haze are the reasons you really don’t want to overdo this,” Dr. Steinert said. “A lot of these people had myopia to begin with. If they are already a little hyperopic, then you may have to relift the flap and do a slight hyperopic treatment later to tune them up.”