PHOTOTHERAPEUTIC KERATECTOMY IN RECURRENT CORNEAL EROSIONS REFRACTORYTO OTHER FORMS OF TREATMENT

Background: Recurrent corneal erosions can occur as a sequel of trauma , of dystrophies or spontaneously. Therapeutic options include topical lubricating and desiccating agents, therapeutic contact lenses, anter ior stromal puncture and, most recently, phototherapeutic keratectomy. At present there are no studies available assessing the value of thes e different therapeutic options. Methods: Fifteen eyes of 12 patients underwent therapeutic excimer photoablation after failure of other for ms of treatment (lubricating agents in all cases, therapeutic contact lenses in 8, anterior stromal puncture in 2). Ablation depth was 5 mu m, except in patients with stromal dystrophy or myopia (6 eyes), who h ad a deeper ablation. Results: After a first photokeratectomy 9 eyes r emained asymptomatic (mean follow-up 12.8 months), 2 eyes had persiste nt symptoms and 4 had recurrent corneal erosions after 1-24 months. Th e chance of success after one treatment was 60% after 12 months as cal culated by the Kaplan-Meier method. Conclusions: The method of photoab lation as applied in this study has a similar chance of success to oth er surgical methods such as anterior surgical stromal puncture. Patien ts included in this study, however, were highly selected and were refr actory to other forms of treatment.