In-Depth Analysis Of Transepithelial Phototherapeutic Keratectomy (Teptk) In Patients With Corneal Irregularities
Published 2023 - 41st Congress of the ESCRS
Reference: FP11.12 | Type: Free paper | DOI: 10.82333/47p5-7963
Authors: Lena Harling* 1 , Gernot Steinwender 2 , Wolfgang List 2 , Andrea Borenich 3
1Medical University of Graz,Graz,Austria, 2Department of Ophthalmology,Medical University of Graz,Graz,Austria, 3Institute for Medical Informatics, Statistics and Documentation,Medical University of Graz,Graz,Austria
Purpose
The aim of this study was to evaluate visual, refractive and morphological outcomes of tePTK in patients with corneal stromal irregularities and to identify possible preoperative features associated with a favourable outcome.
Setting
Retrospective data analysis of functional and morphological parameters obtained in eyes prior to and 3 to 6 months after tePTK procedures performed at the Medical University of Graz.
Methods
To assess the efficacy and safety of tePTK in eyes with corneal stromal irregularities following parameters were obtained pre- and 3 to 6 months postoperatively: corrected distance visual acuity (CDVA), manifest refractive spherical equivalent (MRSE), refractive astigmatism, topographical astigmatism, corneal higher-order aberrations and corneal densitometry values measured by Scheimpflug tomography, and morphological features of corneal opacification and epithelial thickness measured by optical coherence tomography (OCT).
Results
The study included 45 eyes, with 3 eyes undergoing a second treatment after 3-6 months. The intended ablation depth varied between 66 and 140 µm and was 100 µm in 71% of eyes. Mean CDVA increased from 0.38 ± 0.29 logMAR preoperatively to 0.22 ± 0.25 logMAR postoperatively (p<0.001). CDVA improved by 2 or more lines in 40% and by 1 line in 29% of eyes, while no change of CDVA was observed in 29% of eyes and 1 eye (2%) lost 1 line of CDVA. MRSE and refractive astigmatism did not change significantly from pre- to postoperatively. Improvement in CDVA was significantly correlated to bad preoperative CDVA (R=-0.48) and a high preoperative densitometry value in the anterior part of the central cornea (R=-0.42).
Conclusions
Utilizing the natural masking effect of the epithelium, te-PTK can be considered as a safe and effective approach to reduce stromal surface irregularities. Favourable outcomes can be achieved in eyes with bad initial visual acuity and anterior opacification of the central cornea.