Objective Observation of the clinical outcomes of transepithelial phototherapeutic keratectomy (TPTK) for treatment of recurrent corneal erosion and discussion of the surgery design elements, safety, and effectiveness. Methods This retrospective study included 8 patients (4 males, 4 females, average age 36.6±10.0 years) who suffered recurrent corneal erosions and had TPTK surgeries in one eye by excimer laser at Chongqing Aier Eye Hospital from December 2014 to September 2015. Corneal healing speed, corneal erosion recrudescence, and complications (especially haze) were recorded. Uncorrected visual acuities (UCVAs), intraocular pressures, planned cut depths, central cut depths, and maximum cut depths for the intermittent periods without disease, exacerbation times (before surgery), and 6 months after surgery were compared by paired t-tests. Results None of the 8 patients suffered recurrent corneal erosion during the follow-up period (6-16 months). There were significant differences in the UCVAs for the intermittent periods, exacerbation periods, and at the 6-months follow-up time after surgery (F=5.165, P=0.015), but there was no difference in the UCVAs between the intermittent period and 6 months after surgery. Moreover, there was no post-operative haze, and all eye irritation symptoms improved or disappeared after 4 d. There was no significant difference in the depth of the planned cut depth and the central depth of the actual cut area (t=0, P=1.000), but actual cut central depth was significantly less than the actual maximum peripheral depth (t=-18.63, P<0.001). Conclusion TPTK of recurrent corneal erosion is safe and effective and thus should be considered as an appropriate method to treat this condition.
Nassaralla BR, Nassaralla Junior JJ. Ten-year results of phototherapeutic keratectomy on recurrent corneal erosions[J]. Arq Bras Oftalmol, 2012, 75(1): 33-37. DOI: 10.1590/S0004-274 92012000100007.
[5]
Linke SJ, Steinberg J, Katz T. Therapeutic excimer laser treatment of the cornea[J]. Klin Monbl Augenheilkd, 2013, 230(6): 595-603. DOI: 10.1055/s-0032-1328507.
[6]
Dedes W, Faes L, Schipper I, et al. Phototherapeutic keratectomy (PTK) for treatment of recurrent corneal erosion: Correlation between etiology and prognosis-prospective longitudinal study [J]. Graefes Arch Clin Exp Ophthalmol, 2015, 253(10): 1745- 1749. DOI: 10.1007/s00417-015-2990-6.
[7]
Mehlan J, Steinberg J, Traber L, et al. Recurrence rate and subjective symptoms after standardized (Hamburg protocol) phototherapeutic keratectomy on recurrent corneal erosions[J]. Graefes Arch Clin Exp Ophthalmol, 2016, 254(10): 2005-2009. DOI: 10.1007/s00417-016-3470-3.
[8]
Wilson SE, Marino GK, Medeiros CS, et al. Phototherapeutic keratectomy: science and art[J]. J Refract Surg, 2017, 33(3): 203-210. DOI: 10.3928/1081597X-20161123-01.
[9]
Chan E, Jhanji V, Constantinou M, et al. A randomised controlled trial of alcohol delamination and phototherapeutic keratectomy for the treatment of recurrent corneal erosion syndrome[J]. Br J Ophthalmol, 2014, 98(2): 166-171. DOI: 10. 1136/bjophthalmol-2013-303276.
[10]
Luger MH, Ewering T, Arba-Mosquera S. Consecutive myopia correction with transepithelial versus alcohol-assisted photorefractive keratectomy in contralateral eyes: one-year results[J]. J Cataract Refract Surg, 2012, 38(8): 1414-1423. DOI: 10.1016/j.jcrs.2012.03.028.
[11]
KymionisGD, Grentzelos MA, Mikropoulos DG, et al. Transepithelial phototherapeutic keratectomy for recurrent corneal erosions in a patient with previous corneal collagen cross-linking[J]. J Refract Surg, 2012, 28(10): 732-734. DOI: 10. 3928/1081597X-20120911-01.
[12]
Rush SW, Matulich J, Rush RB. Long-term outcomes of optical coherence tomography-guided transepithelial phototherapeutic keratectomy for the treatment of anterior corneal scarring[J]. Br J Ophthalmol, 2014, 98(12): 1702-1706. DOI: 10.1136/bjoph- thalmol-2014-305366.
[13]
Rush SW, Han DY, Rush RB. Optical coherence tomography- guided transepithelial phototherapeutic keratectomy for the treatment of anterior corneal scarring[J]. Am J Ophthalmol, 2013, 156(6): 1088-1094. DOI: 10.1016/j.ajo.2013.06.026.
[14]
Han KE, Kim H, Kim NR, et al. Comparison of intraocular pressures after myopic laser-assisted subepithelial keratectomy: tonometry-pachymetry, Goldmann applanation tonometry, dynamic contour tonometry, and noncontact tonometry[J]. J Cataract Refract Surg, 2013, 39(6): 888-897. DOI: 10.1016/j.jcrs.2013.01.035.
[15]
Sadigh AL, Fouladi RF, Hashemi H, et al. A comparison between Goldmann applanation tonometry and dynamic contour tonometry after photorefractive keratectomy[J]. Graefes Arch Clin Exp Ophthalmol, 2013, 251(2): 603-608. DOI: 10.1007/s00417- 012-2142-1.
[16]
Schallhorn JM, Schallhorn SC, Ou Y. Factors that influence intraocular pressure changes after myopic and hyperopic LASIK and photorefractive keratectomy: a large population study[J]. Ophthalmology, 2015, 122(3): 471-479. DOI: 10.1016/j.ophtha.2014.09.033.