PURPOSE: To report the outcomes of contact lens-intolerant patients with keratoconus (KCN) with subepithelial nodules treated with excimer laser phototherapeutic keratectomy (PTK). METHODS: The charts of all contact lens-intolerant patients with KCN who underwent excimer laser PTK for subepithelial nodules were identified using a computer database and were retrospectively reviewed. Preoperative and postoperative visual acuity and method of correction, surgical treatment, epithelial healing, complications, and KCN nodule recurrence were all analyzed. RESULTS: Fifteen eyes of 15 patients with a minimum follow-up of 3 months were reviewed. Mean follow-up time was 23.1 months (SD +/- 42.5 months, range 3-143 months). In 9 eyes, the epithelial defect healed by postoperative day 3 and all eyes healed by postoperative day 6. There was no infection or corneal melting in any of the eyes. After PTK, 11 patients were refit successfully with rigid gas-permeable contact lenses and 4 wore glasses. Three patients had a recurrence of the KCN nodule at 3, 8, and 23 months postoperatively. One of them had a repeat PTK 23 months after the initial surgery, improving to 20/40 with contact lenses at 55 months postoperatively. Another patient decided to have a penetrating keratoplasty, and the third patient is considering repeat PTK or penetrating keratoplasty. CONCLUSION: PTK effectively removed KCN nodules without recurrences in most patients and can be a successful modality to improve contact lens tolerance and delay or avoid more invasive surgery.
PURPOSE: To report the outcomes of contact lens-intolerantpatients with keratoconus (KCN) with subepithelial nodules treated with excimer laser phototherapeutic keratectomy (PTK). METHODS: The charts of all contact lens-intolerantpatients with KCN who underwent excimer laser PTK for subepithelial nodules were identified using a computer database and were retrospectively reviewed. Preoperative and postoperative visual acuity and method of correction, surgical treatment, epithelial healing, complications, and KCN nodule recurrence were all analyzed. RESULTS: Fifteen eyes of 15 patients with a minimum follow-up of 3 months were reviewed. Mean follow-up time was 23.1 months (SD +/- 42.5 months, range 3-143 months). In 9 eyes, the epithelial defect healed by postoperative day 3 and all eyes healed by postoperative day 6. There was no infection or corneal melting in any of the eyes. After PTK, 11 patients were refit successfully with rigid gas-permeable contact lenses and 4 wore glasses. Three patients had a recurrence of the KCN nodule at 3, 8, and 23 months postoperatively. One of them had a repeat PTK 23 months after the initial surgery, improving to 20/40 with contact lenses at 55 months postoperatively. Another patient decided to have a penetrating keratoplasty, and the third patient is considering repeat PTK or penetrating keratoplasty. CONCLUSION: PTK effectively removed KCN nodules without recurrences in most patients and can be a successful modality to improve contact lens tolerance and delay or avoid more invasive surgery.
Authors: George D Kymionis; Michael A Grentzelos; Alexandra E Karavitaki; George A Kounis; Georgios A Kontadakis; Sonia Yoo; Ioannis G Pallikaris Journal: J Ophthalmol Date: 2010-11-02 Impact factor: 1.909
Authors: L Rico-Del-Viejo; M Garcia-Montero; J L Hernández-Verdejo; S García-Lázaro; F J Gómez-Sanz; A Lorente-Velázquez Journal: J Ophthalmol Date: 2017-12-21 Impact factor: 1.909
Authors: B Seitz; L Daas; L Hamon; K Xanthopoulou; S Goebels; C Spira-Eppig; S Razafimino; N Szentmáry; A Langenbucher; E Flockerzi Journal: Ophthalmologe Date: 2021-06-28 Impact factor: 1.174