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. 1997 Jul;81(7):551–554. doi: 10.1136/bjo.81.7.551

Combined PRK and PTK in myopic patients with recurrent corneal erosion

I Kremer 1, M Blumenthal 1
PMCID: PMC1722249  PMID: 9290367

Abstract

AIM—To study the results of combined photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) in myopic patients with recalcitrant recurrent corneal erosion.
METHODS—PRK was performed in 16 eyes with the Visx 20/20 excimer laser at a central 6.0 mm zone, following total epithelial scraping. Subsequently, confluent 3.0 mm zones of PTK were ablated at a depth of 6.0 µm, surrounding the zone of PRK. The follow up period ranged from 26 to 42 months.
RESULTS—Complete alleviation of symptoms was demonstrated and there was no recurrence of corneal erosion. Visual acuity (VA) improved slowly following treatment, with a final uncorrected VA ranging between 6/9 and 6/12. A final myopic spherical equivalent ⩽−1.0 D was found in 14 out of 16 eyes.
CONCLUSIONS—A combination of PRK and PTK is effective in the alleviation of symptoms and prevention of recurrences of corneal erosion. It is suggested that recalcitrant recurrent corneal erosion is a diffuse disease, although it often manifests as a local problem, and therefore extensive excimer laser ablation is required to prevent recurrence and to alleviate symptoms completely.



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Figure 1  .

Figure 1  

PRK-PTK treatment scheme illustrating the central 6 mm diameter zone of PRK, surrounded by confluent 3 mm diameter circular zones of PTK, reaching the corneal limbus (L).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brodrick J. D. Anterior membrane dystrophy following cataract extraction. Br J Ophthalmol. 1979 May;63(5):331–335. doi: 10.1136/bjo.63.5.331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brown N., Bron A. Recurrent erosion of the cornea. Br J Ophthalmol. 1976 Feb;60(2):84–96. doi: 10.1136/bjo.60.2.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Buxton J. N., Constad W. H. Superficial epithelial keratectomy in the treatment of epithelial basement membrane dystrophy. Ann Ophthalmol. 1987 Mar;19(3):92–96. [PubMed] [Google Scholar]
  4. Buxton J. N., Constad W. H. Superficial epithelial keratectomy in the treatment of epithelial basement membrane dystrophy. Cornea. 1987;6(4):292–297. doi: 10.1097/00003226-198706040-00012. [DOI] [PubMed] [Google Scholar]
  5. Cogan D. G., Kuwabara T., Donaldson D. D., Collins E. Microcystic dystrophy of the cornea. A partial explanation for its pathogenesis. Arch Ophthalmol. 1974 Dec;92(6):470–474. doi: 10.1001/archopht.1974.01010010484004. [DOI] [PubMed] [Google Scholar]
  6. Dausch D., Landesz M., Klein R., Schröder E. Phototherapeutic keratectomy in recurrent corneal epithelial erosion. Refract Corneal Surg. 1993 Nov-Dec;9(6):419–424. [PubMed] [Google Scholar]
  7. Fogle J. A., Kenyon K. R., Stark W. J., Green W. R. Defective epithelial adhesion in anterior corneal dystrophies. Am J Ophthalmol. 1975 Jun;79(6):925–940. doi: 10.1016/0002-9394(75)90674-1. [DOI] [PubMed] [Google Scholar]
  8. Fountain T. R., de la Cruz Z., Green W. R., Stark W. J., Azar D. T. Reassembly of corneal epithelial adhesion structures after excimer laser keratectomy in humans. Arch Ophthalmol. 1994 Jul;112(7):967–972. doi: 10.1001/archopht.1994.01090190115030. [DOI] [PubMed] [Google Scholar]
  9. Frangieh G. T., Kenyon K. R., Wagoner M. D., Hanninen L., John T., Steinert R. F. Epithelial abnormalities and sterile ulceration of epikeratoplasty grafts. Ophthalmology. 1988 Feb;95(2):213–227. doi: 10.1016/s0161-6420(88)33207-0. [DOI] [PubMed] [Google Scholar]
  10. Geggel H. S. Successful treatment of recurrent corneal erosion with Nd:YAG anterior stromal puncture. Am J Ophthalmol. 1990 Oct 15;110(4):404–407. doi: 10.1016/s0002-9394(14)77021-7. [DOI] [PubMed] [Google Scholar]
  11. Gibralter R., Trokel S. L. Correction of irregular astigmatism with the excimer laser. Ophthalmology. 1994 Jul;101(7):1310–1315. doi: 10.1016/s0161-6420(94)31174-2. [DOI] [PubMed] [Google Scholar]
  12. Goldman J. N., Dohlman C. H., Kravitt B. A. The basement membrane of the human cornea in recurrent epithelial erosion syndrome. Trans Am Acad Ophthalmol Otolaryngol. 1969 May-Jun;73(3):471–481. [PubMed] [Google Scholar]
  13. Gyldenkerne G. J., Ehlers N. Excimer-laserbehandling af recidiverende korneale erosioner. Ugeskr Laeger. 1994 Sep 12;156(37):5282–5284. [PubMed] [Google Scholar]
  14. Hykin P. G., Foss A. E., Pavesio C., Dart J. K. The natural history and management of recurrent corneal erosion: a prospective randomised trial. Eye (Lond) 1994;8(Pt 1):35–40. doi: 10.1038/eye.1994.6. [DOI] [PubMed] [Google Scholar]
  15. John M. E., Van der Karr M. A., Noblitt R. L., Boleyn K. L. Excimer laser phototherapeutic keratectomy for treatment of recurrent corneal erosion. J Cataract Refract Surg. 1994 Mar;20(2):179–181. doi: 10.1016/s0886-3350(13)80161-7. [DOI] [PubMed] [Google Scholar]
  16. Khodadoust A. A., Silverstein A. M., Kenyon D. R., Dowling J. E. Adhesion of regenerating corneal epithelium. The role of basement membrane. Am J Ophthalmol. 1968 Mar;65(3):339–348. doi: 10.1016/0002-9394(68)93082-1. [DOI] [PubMed] [Google Scholar]
  17. McDermott M. L., Chandler J. W. Therapeutic uses of contact lenses. Surv Ophthalmol. 1989 Mar-Apr;33(5):381–394. doi: 10.1016/0039-6257(89)90015-5. [DOI] [PubMed] [Google Scholar]
  18. McLean E. N., MacRae S. M., Rich L. F. Recurrent erosion. Treatment by anterior stromal puncture. Ophthalmology. 1986 Jun;93(6):784–788. [PubMed] [Google Scholar]
  19. O'Brart D. P., Muir M. G., Marshall J. Phototherapeutic keratectomy for recurrent corneal erosions. Eye (Lond) 1994;8(Pt 4):378–383. doi: 10.1038/eye.1994.90. [DOI] [PubMed] [Google Scholar]
  20. Ohman L., Fagerholm P., Tengroth B. Treatment of recurrent corneal erosions with the excimer laser. Acta Ophthalmol (Copenh) 1994 Aug;72(4):461–463. doi: 10.1111/j.1755-3768.1994.tb02797.x. [DOI] [PubMed] [Google Scholar]
  21. Poirier L., Coulon P., Williamson W., Mortemousque B., Verin P. Résultats de la photokératectomie thérapeutique par laser Excimer. A propos de 12 cas. J Fr Ophtalmol. 1994;17(4):262–270. [PubMed] [Google Scholar]
  22. Rodrigues M. M., Fine B. S., Laibson P. R., Zimmerman L. E. Disorders of the corneal epithelium. A clinicopathologic study of dot, geographic, and fingerprint patterns. Arch Ophthalmol. 1974 Dec;92(6):475–482. doi: 10.1001/archopht.1974.01010010489005. [DOI] [PubMed] [Google Scholar]
  23. Rubinfeld R. S., Laibson P. R., Cohen E. J., Arentsen J. J., Eagle R. C., Jr Anterior stromal puncture for recurrent erosion: further experience and new instrumentation. Ophthalmic Surg. 1990 May;21(5):318–326. [PubMed] [Google Scholar]
  24. Rubinfeld R. S., MacRae S. M., Laibson P. R. Successful treatment of recurrent corneal erosion with Nd:YAG anterior stromal puncture. Am J Ophthalmol. 1991 Feb 15;111(2):252–255. doi: 10.1016/s0002-9394(14)72277-9. [DOI] [PubMed] [Google Scholar]
  25. Tripathi R. C., Bron A. J. Ultrastructural study of non-traumatic recurrent corneal erosion. Br J Ophthalmol. 1972 Feb;56(2):73–85. doi: 10.1136/bjo.56.2.73. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Tuunanen T. H., Tervo T. M. Excimer laser phototherapeutic keratectomy for corneal diseases: a follow-up study. CLAO J. 1995 Jan;21(1):67–72. [PubMed] [Google Scholar]
  27. Waring G. O., 3rd, Rodrigues M. M., Laibson P. R. Corneal dystrophies. I. Dystrophies of the epithelium, Bowman's layer and stroma. Surv Ophthalmol. 1978 Sep-Oct;23(2):71–122. doi: 10.1016/0039-6257(78)90090-5. [DOI] [PubMed] [Google Scholar]
  28. Williams R., Buckley R. J. Pathogenesis and treatment of recurrent erosion. Br J Ophthalmol. 1985 Jun;69(6):435–437. doi: 10.1136/bjo.69.6.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Wood T. O., McLaughlin B. J., Boykins L. G. Electron microscopy of corneal surface microdiathermy. Curr Eye Res. 1985 Aug;4(8):885–895. doi: 10.3109/02713688509095256. [DOI] [PubMed] [Google Scholar]

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