1. Authors have no financial interests
Outcomes of Laser Phototherapeutic Keratectomy for recurrent corneal erosions
Gregory Moloney
Simon Holland
David T.C Lin
Jason Cherry
WCCVI April 2010
Authors have no financial interests

2. Aim
To determine the efficacy and safety of Phototherapeutic Keratectomy (PTK) for recurrent erosion syndrome (RCES)

3. Introduction and Study Criteria
PTK valuable in treatment of RCES
Provincial health plan covered PTK for RCES in 2000
Indications: RCES non-responsive to conventional treatment: gels, hypertonic saline, bandage contact lenses, stromal puncture

4. Methods Patients received PTK between August 2000 and February 2010
Retrospective, non–randomized, consecutive series chart review
Telephone survey of 10%
Patients received PTK between August 2000 and February 2010
Single surgeon
Allegretto Wavelight Laser
Prolate beam, nomogram adjusted for induced myopia

5. Methods: Surgical Procedure
PTK 7.0mm optical zone, with transition 8.9
5-10microns
Manual epithelial removal
Bandage contact lens for 7-14days
Combined with PRK in selective cases

6. Study Population 290 patients (342 eyes treated)
Mean age of patients was 47.0 years
290 patients (342 eyes treated)
Combined PRK/PTK procedures were performed in 40 (11.6%) of the treated eyes
For patients with RCE, the mean duration of symptoms prior to PTK was 35.1 months
Frequency of RCE attacks ranged from daily to every 3-4 months
All patients with RCE had more than one episode of acute erosion despite at least one month of treatment with lubricants and ointments before PTK considered

7. Results: Questionnaire

8. Results
Mean follow-up on telephone survey patients time was 13 months (range: 7-36 months)
Of the patients who did not undergo combined PTK/PRK, refraction data showed a mean spherical equivalent change of –0.1D

9. Safety: Side Effects/Complications
Delayed epithelialization, 36/342 (beyond 1 week)
Haze – mild. No effect on vision (6%)
Infection – 2 eyes: HSV keratitis, Candida
one eye lost >2lines of vision (scarring), awaiting retreatment
Efficacy:
82% of eyes were free of symptoms of acute erosions throughout the follow-up period
nine retreated

10. Conclusions
PTK is a safe and effective treatment for RCES non-responsive to conventional treatment
High efficacy (82%) and safety with only one losing vision
Patient self-reported satisfaction was high – all patients surveyed would have procedure again and reported improved quality of life