Saturday, December 18, 2010

Phototherapeutic Keratectomy

Phototherapeutic keratectomy (PTK) is an eye surgical procedure in which a laser is employed to treat various ocular disorders by removing tissue from the cornea. Phototherapeutic keratectomy allows the removal of superficial corneal opacities and surface irregularities. It is similar to photorefractive keratectomy which is used for the treatment of refractive conditions. The common indications for PTK are corneal dystrophies, scars, opacities, bullous keratopathy.

Phototherapeutic Keratectomy (PTK) Versus Penetrating Keratoplasty (PK) in the Treatment of Lattice Corneal Dystrophy

Phototherapeutic keratectomy has been shown to be a successful treatment for anterior corneal lesions. Traditionally, PKP has been the primary treatment of choice for patients with lattice corneal dystrophy. Given the greater risks and costs associated with penetrating keratoplasty (surgical trauma, graft failure/ rejection/ dehiscence, infection, irregular astigmatism, chronic steroid use, and frequent clinic visits), PTK may provide a safer, cost effective and more efficacious alternative to penetrating keratoplasty (PK) in patients with anterior corneal dystrophies.

Preliminary data from ophthalmological experience suggests a role for phototherapeutic keratectomy as a primary treatment option for lattice patients, as approximately 90% of the patients treated with PTK alone achieved 20/40 or better vision and maintained this vision for four to seven years before requiring further treatment. Patients treated with PTK alone achieved equal or better visual acuity than the PK patients, had faster visual recovery, and had overall greater satisfaction and quality of life. Even though visually significant lesions typically recur in 4 to 7 years and require PTK retreatment, lattice dystrophy also recurs in transplants over a similar period of time and often requires regrafting.