PHOTOTHERAPEUTIC KERATECTOMY AS PRIMARY O PTION BEFORE PENETRATING KERATOPLASTY

Background Argon fluoride excimer laser (193-nm) can perform precise c orneal ablation with submicron accuracy and minimal reaction to the ad jacent tissue. A possible application is anterior lamellar keratectomy to remove superficial corneal opacities and to smooth corneal irregul arities. Patients and methods Between August 1993 and June 1994 we per formed a phototherapeutic keratectomy (PTK) in 35 patients with differ ent corneal diseases by excimer laser (Aesculap-Meditec). 3 cases (2 c orneal dystrophies and 1 patient with a traumatic corneal opacity afte r chemical burn) are described more exactly with operative methods and postoperative results. Results By slitlamp microscopy we observed an improvement of the primary corneal disorder in all cases. Changing of refraction (hyperopic shift and newly formed astigmatism) arose in 2 o ut of 3 patients. Conclusions Phototherapeutic keratectomy by excimer laser represents a secure, less invasive alternative to surgical metho ds promising quicker visual recovery. Often a penetrating keratoplasty can be avoided or delayed.