gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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Results of phototherapeutic keratectomy (PTK) in the treatment of recurrent corneal erosion syndrome (RCES) in dependence of ablation depth and genesis of erosion

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  • corresponding author L. Zumhagen - Klinik und Poliklinik für Augenheilkunde der Universität Münster
  • W. Förster - Klinik und Poliklinik für Augenheilkunde der Universität Münster
  • H. Busse - Klinik und Poliklinik für Augenheilkunde der Universität Münster

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.16.08

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog144.shtml

Published: September 22, 2004

© 2004 Zumhagen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

In the last years PTK has been established as a successful option in the treatment of RCES. This study investigates the relapse rate after PTK treatment in dependence of ablation depth and the genesis of RCES.

Methods

71 eyes with RCES underwent PTK with the Schwind Keratom F. 49 of 60 eyes with post-traumatic erosions were ablated with subepithelial technique and the other twelve transepithelially. Eyes with Map-Dot-Fingerprint-Dystrophy (n=10) were divided into 7 subepithelial and 3 transepithelial PTK treatments. The average ablation depth was 2.64 μm (1.9 to 5.0 μm). Perioperatively all patients got antibiotic eye drops. Ocular lubricating drops were applied for the postoperative long-term aftercare. Follow-up ranged from 2.97 to 7.11 years with a mean of 4.99 years.

Results

Five eyes (71.4%) with Map-Dot-Fingerprint-Dystrophy were free of relapse after subepithelial PTK and another 2 eyes (66.7%) after transepithelial PTK. There is no statistical significant difference concerning applied ablation depth and the erosion genesis in the dystrophy group. Eight eyes (66.7%) with post-traumatic erosions were free of RCES after transepithelial ablation. There is no statistical significant difference concerning applied ablation depth and the genesis of erosion genesis. Subepithelial PTK in eyes with posttraumatic RCES proved to be successful in 36 cases (73.5%). There is a significant correlation (p=0.033) between ablation depth and the genesis of erosion.

Conclusions

We recommend to do a deeper than applied ablation in the Map-Dot-Fingerprint group with RCES to induce the immunohistochemical effect closer to the basal lamina where the metabolic disorder supposed to be. In eyes with RCES of traumatic origin a superficial subepithelial ablation depth (2.5 to 3.0μm) proved to be successful (73.5%) due to local induction of a biochemical cascade at the subepithelial level of the dysmetabolism.