S Giessler1, G I Duncker. 1. Klinik und Poliklinik für Augenheilkunde, Martin Luther Universität Halle-Wittenberg.
Abstract
BACKGROUND: Recurrent corneal erosion is a common clinical disorder characterised by repeated spontaneous breakdown of the corneal epithelium. The pathomechanism is due to abnormalities of the adhesion complex between the corneal epithelium and the stroma. In addition to local medical treatment, bandage lenses, debridement and anterior stromal puncture, patients can also be treated by excimer laser phototherapeutic keratectomy. METHODS: We present a series of 45 eyes where a transepithelial therapeutic excimer photoablation (t-PTK) was carried out after recurrent erosions caused by mechanical trauma. We used the flying spot excimer laser Technolas 217-C (Bausch & Lomb Surgical) and the scanning spot laser MEL70 (Aesculap Meditec). Treatment was performed in the relapse-free period. The zone of ablation measured 6-9 mm and the ablation depth 10-30 microns. The mean follow-up period was 7 months (range 3-22). RESULTS: After the first t-PTK treatment, 41 eyes remained without a relapse, but 8 patients had persistent symptoms, 4 of which had a new epithelial breakdown and in 2 patients a second t-PTK had to be carried out. CONCLUSIONS: T-PTK appears to be a safe and effective procedure for treatment of recurrent corneal erosion. However, relative contraindications, such as a previous chemical burn, must be taken into account.
BACKGROUND: Recurrent corneal erosion is a common clinical disorder characterised by repeated spontaneous breakdown of the corneal epithelium. The pathomechanism is due to abnormalities of the adhesion complex between the corneal epithelium and the stroma. In addition to local medical treatment, bandage lenses, debridement and anterior stromal puncture, patients can also be treated by excimer laser phototherapeutic keratectomy. METHODS: We present a series of 45 eyes where a transepithelial therapeutic excimer photoablation (t-PTK) was carried out after recurrent erosions caused by mechanical trauma. We used the flying spot excimer laser Technolas 217-C (Bausch & Lomb Surgical) and the scanning spot laser MEL70 (Aesculap Meditec). Treatment was performed in the relapse-free period. The zone of ablation measured 6-9 mm and the ablation depth 10-30 microns. The mean follow-up period was 7 months (range 3-22). RESULTS: After the first t-PTK treatment, 41 eyes remained without a relapse, but 8 patients had persistent symptoms, 4 of which had a new epithelial breakdown and in 2 patients a second t-PTK had to be carried out. CONCLUSIONS: T-PTK appears to be a safe and effective procedure for treatment of recurrent corneal erosion. However, relative contraindications, such as a previous chemical burn, must be taken into account.