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Long-term outcomes of optical coherence tomography-guided transepithelial phototherapeutic keratectomy for the treatment of anterior corneal scarring
  1. Sloan W Rush1,2,
  2. Jennifer Matulich2,
  3. Ryan B Rush1,2,3
  1. 1Panhandle Eye Group, Amarillo, Texas, USA
  2. 2Texas Tech University Health Science Center, Amarillo, Texas, USA
  3. 3Southwest Retina Specialists, Amarillo, Texas, USA
  1. Correspondence to Dr Ryan Rush, Southwest Retina Specialists, 7411 Wallace Blvd., Amarillo, TX 79106, USA; Ryanbradfordrush21{at}hotmail.com

Abstract

Aim To report the long-term outcomes of optical coherence tomography (OCT)-guided transepithelial phototherapeutic keratectomy (PTK) for the management of anterior corneal scarring.

Methods The charts of 60 patients (64 eyes) who underwent OCT-guided transepithelial PTK for anterior corneal scarring were retrospectively reviewed. The procedure involved a preoperative OCT-measured depth of treatment calculation to reduce or eliminate corneal scarring, followed by a combined myopic and hyperopic transepithelial excimer laser treatment profile established to attain the desired refractive result. The main outcome measures consisted of change in best spectacle-corrected visual acuity (BSCVA), change in OCT-measured parameters, and change in corneal topography indices.

Results The mean follow-up was 41.0 weeks (range: 12–117 weeks). BSCVA improved from a mean of 0.77 logMAR (0.65–0.89) preoperatively to a mean of 0.34 logMAR (0.21–0.46) postoperatively (p<0.0001). Comparison of preoperative and postoperative corneal topographic indices showed significant improvement in all parameters analysed: corneal cylinder (p=0.0008), surface asymmetry index (p=0.0054), surface regularity index (p=0.0047) and projected visual acuity (p=0.0045). Postoperative spherical equivalent averaged 0.91 (±0.71) dioptres of error from the intended target refractive outcome. Two patients required penetrating keratoplasty and one patient underwent repeat PTK during the study interval.

Conclusions The OCT-guided transepithelial PTK technique described in this study can deliver positive long-term results and predictable refractive outcomes in the treatment of anterior corneal scarring.

  • Cornea
  • Imaging

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