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Umut Karaca, Uzeyir Erdem, Halil I. Altinsoy, Selim Dagli; Wet Field Phototherapeutic Keratectomy is Effective for the Treatment of Macular Dystrophy: Long Term Follow-up Results. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1098.
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To investigate functional outcomes and effectiveness of wet field photo therapeutic keratectomy (PTK) for the treatment of superficial central stromal corneal opacities.
24 eyes of 12 patients with central superficial stromal opacities treated with 193 nm excimer laser PTK between October 2004 and June 2009 were included. Opacities were caused by macular corneal dystrophy in 24 eyes. After epithelial debridement with 20% isopropyl alcohol; PTK was performed under 0.5% topical proparacaine HCL anesthesia. We applied balanced salt solution (BSS) irrigation to the corneal surface to wet and fill the valleys of prominent superficial corneal lesions, and Wet PTK was performed to the protruded stromal opacities and irregularities. The procedure repeated until the clearance of central lesions. Pre-set laser ablation depth was 100 µm; ablation zone was 7 to 9 mm. Actual ablated stromal depth was 65 µm±22 µm. Main outcome measures included uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).
Mean age of the patients was 29.14 (18-68 years). Mean follow up was 4.2 ±2.3 years. UCVA increased from 0.75±0.5 (LogMAR) to 0.32±0.13 (LogMAR) after surgery. BCVA increased from 0.34±0.13 (LogMAR) to 0.16±0.12 (LogMAR) after surgery. There have been no clinically significiant recurrence was confirmed in macular dystrophies during follow up period.
Wet field PTK is effective in removing central stromal opacities and increasing visual acuity, especially for superficial and centrally weighted macular dystrophy cases. More studies with longer follow up times are needed for more definite results to explain the low incidence of recurrences in our series.
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