Long-term Reult of Phototherapeutic Keratectomy With 193-nm Excimer Laer for Macular Corneal Dytrophy

Purpoe To invetigate functional and morphologic long-term outcome of phototherapeutic keratectomy (PTK) in macular corneal dytrophy. Deign Retropective, clinical ingle-center tudy. Method Between October 1990 and February 2004, 10 eye (five oculu dexter, five oculu initer) of 6 patient (mean age, 23 ± 8 year [range, 15 to 37 year]) with uperficial plaque-like opacitie that were caued by macular corneal dytrophy were included. After epithelial debridement and pannu removal, PTK wa performed with the 193 nm MEL 60 excimer laer. Intended laer ablation depth varied from 20 to 100 μm; the repetition rate wa 20/ or 25/, and the pule number wa 1774 ± 502 (range, 976 to 2422). Mean follow-up wa 4.5 ± 3.1 year [maximum, 8.7 year]). Main outcome meaure included: uncorrected viual acuity, bet corrected viual acuity (BCVA), pherical equivalent, keratometric central power, keratometric atigmatim and regularity (emiquantitative claification of Zei keratometry; cale 0 to 3), potoperative “haze,” time interval until complete epithelial cloure, recurrence rate, and neceity of ubequent penetrating keratoplaty (PK). Reult BCVA increaed from 0.3 ± 0.2 before the operation to 0.6 ± 0.1 after the operation; the mean pherical equivalent increaed from −0.9 ± 1.1 diopter to −0.4 ± 1.8 diopter. Mean keratometric central power decreaed from 44.5 ± 0.7 diopter to 42.5 ± 0.6 diopter. During follow-up, recurrence occurred in nine eye (90%) after 3.4 ± 0.4 year. In ix eye, a PK wa performed after an average of 5.0 year (range, 3.7 to 6.7 year). None of the tranplant had a recurrence during the follow-up period. Concluion In uperficial opacitie that are caued by macular corneal dytrophy, PTK can increae BCVA moderately for a limited period of time. Depite poible complication, primary PK till appear to be the definite therapeutic option for patient with macular corneal dytrophy.