Article
Pediatric phototherapeutic keratectomy – safety and efficacy in the period of 11-year follow-up
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Authors
Published: | September 18, 2006 |
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Outline
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Objective
We evaluated efficacy, stability and safety of phototherapeutic keratectomy (PTK) for treatment of superficial corneal opacities, surface irregularities, epithelial instability and failure of reepithelization in our pediatric patients. Authors present also the visual and refractive results after PTK combined with photorefractive keratectomy (PRK) in one procedure.
Methods
The study includes the group of 58 children (64 eyes) aged 0.3 to 18 years (mean: 11,4 years). Postoperative follow-up time ranged from 1 to 11 years (mean: 6.2 years). The main goal of treatment were to improve visual acuity and to reduce or eliminate subjective ocular discomfort: pain, lacrimation and photophobia. Excimer laser NIDEK EC 5000 was used in PTK mode of 3 to 6 mm optical zone, and 4 to 7.5mm transition zone. Thirty three eyes underwent only PTK, and 31 eyes were treated by PTK combined with PRK to reduce preoperative myopia (19 eyes) or hyperopia (12 eyes).
Results
BSCVA was improved in all children, and episodes of ocular pain or discomfort, lacrimation and photophobia diminished. The mean preoperative LogMAR of BSCVA 0.812 (range 0.2 to 1.60) improved to mean value 0.217 (range 0.00 to 0.80) at last visit 1 to 9 years postoperatively. No eye lost a line of BSCVA. Twenty one children had 5 or more Snellen´s lines gain of the BSCVA, seventeen children gained 4 lines. No eye had BSCVA worsened postoperatively. The mean preoperative spherical equivalent (SE) of 17 myopic eyes decreased from -5.76 to -1.39 diopters (D) and the mean SE of 12 hyperopic eyes changed from +4.47 D to +1.73 D by 2 to 5 years after the combined procedure.
Conclusions
PTK in children is safe and effective treatment method of various surface corneal disorders. PTK may significantly improve visual acuity, heal persistent epithelial defects and eliminate ocular pain and irritation. A preoperative refractive error can be reduced by the combined procedure.