Phototherapeutic keratectomy in herpes simplex keratitis. Clinical results in 20 patients.

Twenty eyes in 20 patients with herpetic keratitis were treated with excimer laser photoablation. Sixteen eyes underwent phototherapeutic keratectomy because of scars and surface irregularities, with the goal to improve vision and 1 eye for cosmetic reasons. Two eyes had slight scars but were treated because of a refractive error (PRK). One eye had a metaherpetic ulcer where the wound surface was ablated with the intention to improve healing. Twelve of the 16 eyes showed improved visual acuity of 2 lines or more on the Snellen chart. The refractive outcome was acceptable in the 2 PRK eyes. The cosmetic result was good and the metaherpetic wound epithelialized within 3 weeks. Of the 20 patients 5 had 1 or more recurrences during the 16.8 months of follow-up. In the 17 months preceding the laser surgery 9 eyes had 1 or more recurrences. Three of these eyes still showed improved vision. Phototherapeutic excimer laser surgery is advantageous in selected cases and should be considered before corneal grafting. The procedure does not seem to increase the incidence of recurrences.