PURPOSE: To determine if superficial lamellar corneal excision with femtosecond laser followed by phototherapeutic keratectomy (PTK) using a masking substance improves visual acuity and optical quality of patients with severe corneal opacities. METHODS: Twelve eyes with corneal haze or scarring underwent confocal microscopy to estimate the opacities' thickness and calculate the excision depth. Femtosecond laser was then used to create a superficial corneal flap. PTK and smoothening with masking substance (0.25% sodium hyaluronate) were done to improve corneal regularity and decrease corneal scarring. Follow-up was performed at 1, 6, and 12 months. RESULTS: Mean logarithm of the minimum angle of resolution of best spectacle-corrected visual acuity improved from 0.62 (mean decimal 0.26) to 0.30 (mean decimal 0.58) at 1 year (P = 0.035). Haze grades improved significantly. Coma-like aberration decreased postoperatively. CONCLUSIONS: Results showed that superficial corneal excision with femtosecond laser augmented with PTK laser smoothening assisted with 0.25% sodium hyaluronate improved visual acuity and could be considered as an alternative to more invasive procedures in patients with severe corneal opacities.
PURPOSE: To determine if superficial lamellar corneal excision with femtosecond laser followed by phototherapeutic keratectomy (PTK) using a masking substance improves visual acuity and optical quality of patients with severe corneal opacities. METHODS: Twelve eyes with corneal haze or scarring underwent confocal microscopy to estimate the opacities' thickness and calculate the excision depth. Femtosecond laser was then used to create a superficial corneal flap. PTK and smoothening with masking substance (0.25% sodium hyaluronate) were done to improve corneal regularity and decrease corneal scarring. Follow-up was performed at 1, 6, and 12 months. RESULTS: Mean logarithm of the minimum angle of resolution of best spectacle-corrected visual acuity improved from 0.62 (mean decimal 0.26) to 0.30 (mean decimal 0.58) at 1 year (P = 0.035). Haze grades improved significantly. Coma-like aberration decreased postoperatively. CONCLUSIONS: Results showed that superficial corneal excision with femtosecond laser augmented with PTK laser smoothening assisted with 0.25% sodium hyaluronate improved visual acuity and could be considered as an alternative to more invasive procedures in patients with severe corneal opacities.