Posters

Phototherapeutic keratectomy in eyes with persistent macro-epithelial defects following penetrating keratoplasty

Poster Details

First Author: D. Maltsev RUSSIAN FEDERATION

Co Author(s):    S. Churashov   V. Chernysh   E. Kudryashova              

Abstract Details

Purpose:

Phototherapeutic keratectomy (PTK) is an important treatment for eyes with recurrent corneal erosion syndrome. Reported success rates for this treatment in recurrent corneal erosion varies from 69% to 86%. Persistent macro-epithelial defects following penetraiting keratoplasty may predispose the graft to infectious keratitis and secondary failure. As there are no reports of PTK efficacy for persistent macro-epithelial defects following penetraiting keratoplasty, the objective of this study was to present the outcomes of donor graft persistent macro-epithelial defects treated by “wet” PTK.

Setting:

Department of Ophthalmology Military Medical Academy, St. Petersburg, Russia.

Methods:

This study included patients who had macro-epithelial defects of the donor graft lasting more than 3 months and had failed previous treatment modalities. All procedures were performed using the EC-5000 excimer laser. The “wet” PTK was performed by first flooding the erosion zone with balanced salt solution (acting as a masking agent) followed by a 60-µm ablation. The second step of PTK treatment was performed over the dried graft surface with an ablation depth up to 30 µm. After the procedure a soft contact lens was placed and fixed combination of glucocorticoid and antibiotic was prescribed for 2 weeks.

Results:

Six eyes of 6 patients (3 man and 3 women; mean age 57.3 ± 10.2 years) were treated for persistent macro-epithelial defects of the donor graft with “wet” PTK. Before PTK all patients had failed extended wear of soft contact lenses, amniotic membrane transplantation (1 to 3 procedures) and temporary tarsorrhaphy (2 cases). The mean corrected distant visual acuity was 1.79 ± 0.24 logMAR preoperatively and improved significantly to 1.04 ± 0.21 logMAR 10 days postoperatively (p = 0.027), remains stable during mean follow-up of 5.8 ± 1.6 months. There were no any postoperative complications or recurrence of macro-epithelial defects during follow-up period.

Conclusions:

“Wet” phototherapeutic keratectomy appears to be successful for patients with macro-epithelial defects of the donor graft following penetraiting keratoplasty who have failed conservative measures or previous surgical interventions.

Financial Disclosure:

NONE