PTK for post-traumatic corneas can improve visual acuity, symptoms
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Phototherapeutic keratectomy offers fast recovery, provides symptomatic relief and can improve visual acuity in post-traumatic corneas, according to a speaker.
“Laser surgery in post-traumatic corneas is a recognized treatment modality with little side effect. It offers fast recovery, repeatability and preserves transparency. It can relieve symptoms and improve visual acuity. PTK is a tailored approach for many difference indications, and success rates vary,” Annette J.M. Geerards, MD, FEBOphth, said at the virtual European Society of Cataract and Refractive Surgeons meeting.
Smaller corneal trauma typically requires conservative treatment, but refractory cases, such as scarring after foreign body removal and long-standing irritation after insignificant injuries, can be treated with laser surgery. Phototherapeutic keratectomy (PTK) ablates the corneal stroma, improves corneal clarity, smooths the surface and is less invasive than other surgeries, such as grafting, she said.
PTK can be used to treat patients with recurrent erosion syndrome when other conservative treatment modalities, such as lubricants, patching and hypertonic salt ointment, fail.
“The goal for treatment with PTK is to decrease the number of recurrences by creating better adhesion with the basement membrane. It’s to improve the visual acuity, reduce scar tissue, improve clarity and improve the quality of vision with less halos, less diplopia, less straylight and aberrations,” she said.
Geerards said her hospital used PTK to treat 75 patients with epithelial basement membrane dystrophy and 34 patients with recurrent erosion syndrome in 2018 and 2019. Of the 109 patients, 75% had no recurrences in the 6-month follow-up period, and 2% required a second PTK treatment. No patients experienced significant refractive change or significant haze, Geerards said.
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Geerards A. Laser refractive surgery in the post traumatic cornea. Presented at: European Society of Cataract and Refractive Surgeons meeting; Oct. 2-4, 2020 (virtual meeting).
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