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Retreatment rates for recurrent corneal erosion syndrome following excimer laser phototherapeutic keratectomy

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Session Details

Session Title: Moderated Poster Session: News on Cornea

Venue: Poster Village: Pod 1

First Author: : S.Naylor UK

Co Author(s): :    R. Darbyshire   S. Anand   A. Morrell   J. Ball     

Abstract Details

Purpose:

Recurrent corneal erosion syndrome (RCES) is a common clinical disorder associated with debilitating ocular symptoms and significant visual morbidity1. The condition is chronically recurrent in nature and is characterised by a frustratingly poor response to conservative management. Excimer laser Phototherapeutic Keratectomy (PTK) is reserved for severe and refractory cases. Literature regarding re-treatment rates following primary treatment is lacking. Our study investigates the rate of recurrence following first PTK and risk factors for treatment failure.

Setting:

St James's University Teaching Hospital, Leeds, West Yorkshire, United Kingdom

Methods:

Patients undergoing PTK between 1st January 2015 and 31st December 2015 were retrospectively identified. The protocol involved corneal epithelial debridement ± ethanol, followed by PTK with a 12μm ablation depth and 8μm zone. Post-operative topical management involved G. ofloxacin 0.3% QDS for 7 days, prednisolone minims 0.5% QDS for 2 weeks, ongoing G. sodium hyaluronate 0.15% QDS. 2 sachets of proxymetacaine were provided for the immediate post-operative period.

Results:

68 PTK treatments were undertaken in the 12 month period. Indications included 10 cases of non-dystrophic RCES, 22 traumatic RCES, 34 dystrophic RCES and 2 other (one post penetrating keratoplasty and one Salzmann nodular degeneration). 9 (13%) experienced a further flare. 7 of these occurred within 12 months of the initial PTK treatment. 1 occurred after intravitreal anti-VEGF treatment. 6 of the 9 treatment failures were associated with poor compliance with post-operative topical medication.

Conclusions:

PTK successfully resolved 87% of RCES cases which had failed medical management. The 13% treatment failure was similar to other studies published in this area. Poor compliance with topical mediations is a previously unidentified risk factor for treatment failure.

Financial Disclosure:

NONE

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