Customized Photo-Therapeutic Keratectomy (Ptk) For Recurrent Corneal Erosion (Rce) Syndrome

Recurrent corneal erosion (RCE) syndrome occurs due to abnormal adhesion of the corneal epithelium to the basal lamina. Poor adhesion leads to frequent breakdown of corneal epithelium, causing pain, lacrimation, photophobia and blurring of vision, typically early in the morning. Conservative management offers a temporary relief of symptoms. When conservative management fails, a large-zone PTK is planned, which ablates a large amount of tissue, often causing a hyperopic shift. In an attempt to optimize the amount of tissue ablation in such cases, we attempted to develop a novel technique - a customized phototherapeutic keratectomy (PTK) for recurrent corneal erosion syndrome. 

Department of Cornea and Refractive Services at Narayana Nethralaya, Bangalore

We studied a case series of 11 patients with RCE syndrome, not responding to conversative therapy. A customized trans-epithelial phototherapeutic keratectomy (PTK) was planned for them, using the PTK-CAM module of Schwind Amaris RS1050. The affected area was measured and ablated to a depth of 25 microns beyond the thinnest epithelial thickness using an excimer laser.

During the subsequent visits of all the 11 patients, a complete resolution of symptoms was noted without any refractive surprises. The healing was found to be faster as compared to the other conventional surface treatment modalities

Customized PTK is a safe and effective tissue-sparing technique for treating RCE syndrome that is refractory to medical treatment with better visual outcome and patient satisfaction.