PHOTOTHERAPEUTIC KERATECTOMY FOR CLIMATIC DROPLET KERATOPATHY

BACKGROUND: Phototherapeutic keratectomy (PTK) is an effective treatme nt for many superficial corneal disorders. The efficacy of PTK for the treatment of climatic droplet keratopathy (CDK) has not been reported . METHODS: We report the results of excimer laser (Summit Technology, Inc, Waltham, Mass) PTK on 75 eyes (67 patients) with ''smooth'' clima tic droplet keratopathy (55 eyes) and ''irregular'' climatic droplet k eratopathy (20 eyes) in whom more than 6 months of follow up are avail able. RESULTS: PTK was successful in reducing corneal opacification in both smooth (98%) climatic droplet keratopathy and irregular (80%) cl imatic droplet keratopathy. Achievement of a clear or mildly hazy corn ea following PTK was more likely to occur with smooth (80%) climatic d roplet keratopathy than irregular (25%) climatic droplet keratopathy ( P=0.01). Eyes with smooth climatic droplet keratopathy were more likel y to obtain more than one line of improved uncorrected (56% vs. 25%) o r spectacle-corrected visual acuity (61.8% vs. 21.2%) than those with irregular climatic droplet keratopathy (P=0.03 and 0.005, respectively ). Delayed re-epithelialization (longer than 14 days) was more common in irregular CDK (21%) than in smooth CDK (9%), as was the incidence o f secondary microbial keratitis (10.0% vs. 1.8%). CONCLUSIONS: PTK is effective in reducing superficial corneal opacification in CDK, althou gh serious complications may occur, especially in advanced irregular C DK.