Comparison of corneal densitometry and aberration between transepithelial phototherapeutic keratectomy and topical Tacrolimus in treatment of adenoviral corneal subepithelial infiltrates
First Author: T.Elhamaky EGYPT
To compare the changes in corneal densitometry and aberrations between topical tacroliums and transepithelial phototherapeutic keratectomy (Te-PTK) in the treatment of adenoviral corneal subepithelial infiltrates (SEI).
This is an interventional prospective randomized study, included 70 eyes of 45 patients with symptomatic adenoviral corneal SEI for at least 1 year. All patients underwent previous topical steroids treatment with unsatisfactory response or complications.
Patients were assigned into 3 groups; (1) Te-PTK group: transepithelial phototherapeutic keratectomy (PTK) with MMC 0.02% was performed by a Technolas; Teneo excimer laser. (2) Tacrolimus group: topical tacrolimus 0.03 % ointment was applied once daily for a course of 12-24 weeks. (3) Control group: no intervention was done. BCVA, corneal densitometry and total corneal higher order aberrations (HOAs) evaluation using pentacam HR were done at baseline, 1 week, then 1, 3, 6 and 12 months of study.
At 12 months follow-up, the mean BCVA improved from in Te-PTK and tacrolimus groups. The mean corneal densitometry of anterior cornea, central cornea and total cornea decreased significantly in the Te-PTK and tacrolimus groups. HO-RMS and total RMS decreased significantly in the Te-PTK and tacrolimus groups. BCVA, corneal densitometry and aberrations values were significantly better for the TE-PRK and tacrolimus groups than the control group. There were no statistically significant differences between TE-PRK and tacrolimus groups in terms of BCVA, corneal densitometry and aberrations. The persistence of corneal SEI was lower in Te-PTK than tacrolimus, and control groups.
Te-PTK and topical tacrolimus are effective methods for treatment of corneal subepithelial infiltrates after adenoviral keratoconjunctivitis improving visual acuity, corneal densitometry and aberration.