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P. Vinciguerra, I. Torres Munoz, F. Camesasca, F. Grizzi, C. Roberts, D. Epstein; Long–term Follow–up of Ultrathin Corneas Retreated With Phototherapeutic Keratectomy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4647.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the role of phototherapeutic keratectomy (PTK) as an alternative to penetrating keratoplasty (PK) in patients with corneal thickness less than 400mµ and cornea–related visual problems. Methods: We retrospectively studied 48 eyes which were treated with PTK for complications following photorefractive keratectomy (PRK). In all eyes over 200mµ of stroma had been ablated in the PRK procedures. Mean (±SD) pre–PTK BSCVA was 0.2±0.09, mean spherical equivalent (SE) –2.53D±2.34D, and mean pachymetry 390mµ±38mµ. Follow–up was 5 years. Efficacy parameters considered were pachymetry and VA at one year. Refraction and corneal curvature from 1 to 5 years were used as stability parameters. PTK was performed with a Nidek EC 5000 laser (10 Hz, 10–mm ablation diameter) with intraoperative masking fluid and topography. Results: At one year after PTK, mean BSCVA was 0.6±0.72, mean SE –2.15D±1.67D and mean pachymetry 341mµ±40mµ. At five years, mean BSCVA was 0.7±0.15, mean SE –2.33D±1.12D and mean pachymetry 339mµ±48mµ. In all eyes BSCVA improved by at least 4 Snellen lines. Statistical evaluation of refraction and corneal curvature at one year at five years after PTK showed no significant differences. No eye developed ectasia. Conclusions: These results indicate that post–PRK eyes with ultrathin corneas and cornea–related visual problems can be treated with PTK as an alternative to PK. Despite a mean post–PTK pachymetry of 339mµ, all eyes in this study showed a significant improvement of BSCVA, as well as long–term stability of refraction and corneal curvature.
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