Article
Long-term outcome of excimer-laser phototherapeutic keratectomy (o-PTK) for treatment of Salzmann's nodular degeneration
Search Medline for
Authors
Published: | September 22, 2004 |
---|
Outline
Text
Objective
To describe the technique and evaluate the long-term success of excimer laser phototherapeutic keratectomy (o-PTK) for treatment of Salzmann's nodular degeneration.
Methods
This retrospective study comprised 22 eyes of 14 patients, who had consecutively undergone o-PTK for superficial corneal opacities in Salzmann's nodular degeneration between January 1990 and November 2003. In all cases, the nodules and as much pannus tissue as possible were removed with a hockey knife. Afterwards, the laser ablation (MEL 60 or 70, Carl Zeiss-Meditec, Jena, Germany) was performed with repeated application of masking fluid to remove further scar tissue and smoothen the surface. Intended depth of laser ablation ranged from 10 to 168 μm (mean: 58 ± 63 μm).
Results
In 83% eyes visual acuity improved after PTK, from 0.4 ± 0.2 preoperatively to 0.6 ± 0.3 postoperatively. The mean myopic shift was 0.3 ± 0.3 D. Median refractive cylinder changed from 1.0D preoperatively to 0.7D postoperatively. The surface regularity index/surface asymmetry index (SRI/SAI) of the TMS-1 topography analysis system (Tomey, Erlangen, Germany) decreased from 2.0/1.6 preoperatively to 1.2/1.2 postoperatively. In 3 (14%) out of 22 eyes, recurrence had to be treated by repeat PTK during a mean follow-up of 2.0 ± 1.8 years.
Conclusions
PTK apprears to be an effective and safe procedure for treatment of Salzmann's nodular degeneration. Lasr ablation should be combined with prior conventional removal of nodules and excessive pannus tissue.