Recurrence Rate Of Recurrent Corneal Erosions After Implementation Of A Modified Protocol Of Excimer Laser Phototherapeutic Keratectomy

Phototherapeutic keratectomy (PTK) has been used to treat Recurrent Corneal Erosions (RCE) and our previous success rate was 80% with some cases requiring retreatment. However the recurrence rate of RCE after PTK varies in previously reported publications. We present our results after implementing a new protocol for PTK in a large tertiary referral Eye Unit.

We present a single centre retrospective observational study looking at the recurrence, complications and post-op vision in patients with RCE after PTK treatment.

The electronic records of all adult patients who underwent PTK at Moorfields Eye Hospital in London, UK between 2020 – 2023 were retrospectively analysed for indication, visual acuity, keratometric changes post op complications and recurrence. Patients were followed up from 6 months to 1 year post PTK. The new PTK protocol included manual epithelial removal and deeper ablation with larger diameter (15 microns and 10 mm). The Schwind Amaris 1050 laser was used in this study and patient’s own keratometric values were introduced in the programming of the laser.

Out of 74 eyes that had PTK performed in that period, 44 eyes had a diagnosis of RCE. This was secondary to trauma or an anterior corneal dystrophy. Of those with RCE, 52% were male and 48% were female. The average age was 42.1 years (range: 23 – 66 years). There was 2% (1/44) rate of RCE recurrence. Other complications included 1 case of symptomatic residual astigmatism and 1 case of superficial corneal haze. There was no significant difference between keratometry and visual acuity before and after the procedure.

This study provides evidence that this new PTK protocol with deeper stromal ablation is a more effective treatment option for RCE. Mild corneal haze was observed in only one case and mitomycin C is not required.