Abstract
Purpose To report on the outcome of excimer phototherapeutic keratectomy (PTK) in the management of band keratopathy.
Methods Analysis was performed on patients undergoing PTK for band keratopathy between January 1996 and December 1999. Patients were assessed as to whether the indication for PTK was for visual rehabilitation (visual group) or for ocular surface improvement (nonvisual group). Further data including pre- and postoperative best-corrected visual acuity, pre- and postoperative spherical equivalent (SE), and associated or previous ocular pathology were collected.
Results A total of 45 eyes of 33 patients underwent PTK for band keratopathy. In the visual group, there were 33 eyes of 22 patients, and in the nonvisual group 12 eyes of 11 patients. The visual acuity was improved or unchanged in 18/33 eyes (55%) of the visual group, while there was loss of one or more lines of acuity in 15/33 (45%). Loss of acuity was attributed to other factors in 11/15 eyes. There was a significant myopic shift (P<0.5) from the mean preoperative SE of+1.42 D (SD±3.21 D) to the mean postoperative SE of +0.32 (SD±3.26 D). Of the eyes in the nonvisual group, 10/12 (83%) had significant improvement of symptoms.
Conclusion Excimer PTK is an effective procedure in the management of band keratopathy whether it is performed for visual rehabilitation or for ocular surface improvement to prevent erosions. Concurrent pathology is common and may limit the extent of visual improvement postoperatively. Factors associated with the myopic shift seen in this series may be epithelial remodelling, concurrent ocular pathology, or inaccuracy of preoperative refractive data.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Sher NA, Bowers RA, Zabel RW et al. Clinical use of the 193-nm excimer laser in the treatment of corneal scars. Arch Ophthalmol 1991; 109: 491–498.
Stark WJ, Chamon W, Kamp MT et al. Clinical follow-up of 193-nm ArF excimer laser photokeratectomy. Ophthalmology 1992; 99: 805–812.
Campos M, Nielsen S, Szerenyi K et al. Clinical follow-up of phototherapeutic keratectomy for treatment of corneal opacities. Am J Ophthalmol 1993; 115: 433–440.
Maloney RK, Thompson V, Ghiselli G et al. A prospective multicenter trial of excimer laser phototherapeutic keratectomy for corneal vision loss. The Summit PTK Study Group. Am J Ophthalmol 1996; 122: 149–160.
Bernauer W, De Cock R, Dart JK . Phototherapeutic keratectomy in recurrent corneal erosions refractory to other forms of treatment. Eye 1996; 10: 561–564.
Cavanaugh TB, Lind RM, Cutarelli PE et al. Phototherapeutic keratectomy for recurrent erosion syndrome in anterior basement membrane dystrophy. Ophthalmology 1999; 106: 971–976.
Gartry D, Kerr-Muir M, Marshall J . Excimer laser treatment of corneal surface pathology: a laboratory and clinical study. Br J Ophthalmol 1991; 75: 258–269.
Fagerholm P, Fitzsimmons TD, Örndahl MJ et al. Phototherapeutic keratectomy with the excimer laser: long term follow-up results in 166 treated eyes. Refractive Corneal Surg 1993; 9: S76S81.
Cursino JW, Fine BS . A histologic study of calcific and non–calcific band keratopathies. Am J Ophthalmol 1976; 82: 395–404.
O'Brart DPS, Gartry DS, Lohmann CP et al. Treatment of band keratopathy by excimer laser phototherapeutic keratectomy: surgical techniques and long term follow up. Br J Ophthalmol 1993; 77: 702–708.
Dighiero P, Boudraa R, Ellies P et al. Therapeutic photokeratectomy for the treatment of band keratopathy. J Fr Ophtalmol 2000; 27: 345–349.
Amano S, Oshika T, Tazawa Y et al. Long-term follow-up of excimer laser phototherapeutic keratectomy. Jpn J Ophthalmol 1999; 43: 513–516.
Amm M, Duncker GI . Refractive changes after phototherapeutic keratectomy. J Cataract Refractive Surg 1997; 23: 839–844.
Dogru M, Katakami C, Miyashita M et al. Ocular surface changes after excimer laser phototherapeutic keratectomy. Ophthalmology 2000; 107: 1144–1152.
Salah T, El Maghraby A, Waring III GO . Excimer laser phototherapeutic keratectomy before cataract extraction and intraocular lens implantation. Am J Ophthalmol 1996; 122: 340–348.
Author information
Authors and Affiliations
Corresponding author
Additional information
This work was presented as a poster at the Royal College of Ophthalmologists Annual Congress Meeting in Birmingham, May 2001
Rights and permissions
About this article
Cite this article
Stewart, O., Morrell, A. Management of band keratopathy with excimer phototherapeutic keratectomy: visual, refractive, and symptomatic outcome. Eye 17, 233–237 (2003). https://doi.org/10.1038/sj.eye.6700327
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6700327
Keywords
This article is cited by
-
Transepithelial phototherapeutic keratectomy for the treatment of severe band keratopathy
International Ophthalmology (2020)
-
Risk of Band Keratopathy in Patients with End-Stage Renal Disease
Scientific Reports (2016)
-
Uveitic band keratopathy: child and adult
Journal of Ophthalmic Inflammation and Infection (2015)
-
Phototherapeutische Keratektomie
Der Ophthalmologe (2006)
-
Phototherapeutische Keratektomie
Der Ophthalmologe (2006)
