gms | German Medical Science

104th DOG Annual Meeting

21. - 24.09.2006, Berlin

Pediatric phototherapeutic keratectomy – safety and efficacy in the period of 11-year follow-up

Meeting Abstract

  • R. Autrata - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • J. Řehůřek - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • I. Helmanová - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • S. Pyrochtová - Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic

Deutsche Ophthalmologische Gesellschaft e.V.. 104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG). Berlin, 21.-24.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dogP128

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2006/06dog650.shtml

Published: September 18, 2006

© 2006 Autrata 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

Text

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.