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J Cataract Refract Surg. 2005 Jan;31(1):82-7.

Long-term follow-up of ultrathin corneas after surface retreatment with phototherapeutic keratectomy.

Author information

1
Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano-Milan, Italy. pvinciguerra@vincieye.it

Abstract

PURPOSE:

To evaluate visual acuity and long-term stability after phototherapeutic keratectomy (PTK) in patients with corneal thickness less than 400 microm and cornea-related vision problems.

SETTING:

Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano-Milan, Italy.

METHODS:

This retrospective study comprised 48 eyes that had PTK for complications after photorefractive keratectomy that removed more than 200 microm of tissue. Phototherapeutic keratectomy was performed with the Nidek EC-5000 excimer laser with 10 Hz frequency, intraoperative topography, and masking fluid over an ablation diameter of 10.0 mm. The follow-up was 5 years. The mean preoperative best spectacle-corrected visual acuity (BSCVA) was 0.2 +/- 0.09 (SD) with -2.53 +/- 2.34 diopters (D), and the mean pachymetry was 390 +/- 38 microm. The efficacy parameters were pachymetry and visual acuity at 1 year and the stability parameters, optical refraction, corneal curvature (calculated as the mean curvature over the entire 3.0 mm and 5.0 mm central zones), and pachymetry from 1 to 5 years.

RESULTS:

At 1 year, the mean BSCVA was 0.6 +/- 0.72 with -2.15 +/- 1.67 D and the mean pachymetry, 341 +/- 40 microm. At 5 years, the mean BSCVA was 0.7 +/- 0.15 with -2.33 +/- 1.12 D and the mean pachymetry, 339 +/- 48 microm. In all patients, there was an improvement of 4 or more Snellen lines. Statistical evaluation of refraction and corneal curvature values at 1 and 5 years indicated no statistically significant differences.

CONCLUSIONS:

After PTK in eyes with ultrathin corneas, there was significant improvement in BSCVA and long-term stability of the optical refraction, corneal curvature, and pachymetry. In selected cases, 10.0 mm ablation zone PTK may be an alternative to penetrating keratoplasty, offering long-term corneal stability.

PMID:
15721699
DOI:
10.1016/j.jcrs.2004.10.039
[Indexed for MEDLINE]

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