Posters

Phototherapeutic keratectomy followed by topography-guided photorefractive keratectomy in the treatment of refractive error with dense corneal scarring

Poster Details

First Author: A.Shortt UK

Co Author(s):    S. Vaswani                    

Abstract Details

Purpose:

To report the effectiveness of a multi-stage therapeutic treatment plan in a patient seeking corneal refractive surgery with an existing dense corneal scar.

Setting:

Private hospital setting, the Optegra Eye Hospitals, UK.

Methods:

A three-step plan was devised for a patient attending for a refractive consultation with the goal of being spectacle free. The patient’s left cornea was markedly irregular due to the presence of a longstanding dense nasal scar and moderate myopia was noted. Two phototherapeutic keratectomy (PTK) treatments were carried out to reduce the level of scarring and corneal irregularity, followed by a topography guided photorefractive keratectomy (PRK) procedure to fully regularise the cornea and correct existing refractive error. All three treatments were carried out using the Zeiss MEL 90 excimer laser (Carl Zeiss Meditec, Germany)

Results:

The cornea was regularised and the density of the scar reduced significantly after all treatments had been completed. Best corrected visual acuity pre-operatively was found to be 6/12 which improved to 6/9 unaided post-operatively and 6/7.5 with residual refraction. Visual quality significantly improved and a noticeable reduction in refractive error was recorded.

Conclusions:

This case study demonstrates the effectiveness of combining PTK and topography-guided PRK for the treatment of refractive error in the presence of corneal irregularity caused by scarring.

Financial Disclosure:

None