TREATMENT OF BAND KERATOPATHY BY EXCIMER-LASER PHOTOTHERAPEUTIC KERATECTOMY - SURGICAL TECHNIQUES AND LONG-TERM FOLLOW-UP

A series of. 122 eyes with band keratopathy was treated by excimer las er phototherapeutic keratectomy (PTK), with a mean follow up of over 1 2.3 months (range 3 to 60 months). A single photoablation zone was use d to remove the opacity over the visual axis in smooth surfaced band d eposition. In eyes with reduced vision, an improvement was reported in 88% and in a series of 66 eyes mean Snellen visual acuity increased s ignificantly (p<0.05, t=2.27). A reduction in glare was reported in 88 % and in a series of 17 patients, visual contrast sensitivity (p<0.01) and measurements of disability glare (p<0.01) improved postoperativel y. The mean hyperopic shift in 32 eyes at 6 months was 1.4 D (range 0- 4.25 D). Multiple overlapping ablation zones, with mechanical debulkin g of large calcium plaques, were used to smooth the irregular corneal surface in eyes with rough bands. Ocular discomfort was improved in 95 %. Band keratopathy recurred in nine eyes (8%) within 2 to 30 months ( mean 12 months) of surgery, with silicone oil responsible in five eyes . Reablation was necessary in three eyes and performed successfully in all cases. Excimer laser PTK is a safe and effective outpatient treat ment for band keratopathy.