Abstract
PurposeTo evaluate hyperopia-correcting phototherapeutic keratectomy (HC-PTK) and to compare the visual and refractive outcomes of HC-PTK and conventional PTK.MethodsThis study comprised a total of 72 eyes of 72 consecutive patients who underwent HC-PTK and conventional PTK for granular corneal dystrophy or band-shaped keratopathy. Preoperatively and 6 months postoperatively, we assessed visual acuity, manifest refraction, and mean keratometry, as well as postoperative corneal higher-order aberrations and adverse events in each PTK group, and compared these metrics between the two groups.ResultsLogMAR BSCVA significantly improved from 0.43 ± 0.47 preoperatively to 0.21 ± 0.38 postoperatively in the HC-PTK group (Wilcoxon signed-rank test, p < 0.001). It was also significantly improved from 0.22 ± 0.21 preoperatively to 0.15 ± 0.12 postoperatively in the conventional PTK group (p = 0.031). Mean refraction significantly changed from 0.27 ± 1.55 diopter (D) preoperatively to 0.50 ± 1.77 D postoperatively, in the HC-PTK group (p = 0.313). By contrast, it was significantly hyperopic from −0.15 ± 2.41 D preoperatively to 1.45 ± 2.46 D postoperatively, in the conventional PTK group (p < 0.001). No significant complications occurred in any case during the follow-up period.ConclusionBoth HC-PTK and conventional PTK showed a significant improvement of BSCVA and no vision-threatening complications at any time in this series. HC-PTK significantly reduced a hyperopic shift in refraction compared with conventional PTK, suggesting its viability for patients requiring PTK, especially in consideration of preventing this hyperopic issue.
Highlights
Phototherapeutic keratectomy (PTK) has been widely acknowledged to be a safe and effective means to remove diseased tissue by the use of excimer laser photoablation in eyes having opaque corneas such as granular corneal dystrophy (GCD) and band-shaped keratopathy (BSK) [1–7]
Our results demonstrated that both HCPTK and conventional PTK provided a significant improvement of best spectaclecorrected visual acuity (BSCVA) and that there were no significant intraoperative or postoperative complications, suggesting its viability as a surgical treatment for GCD and BSK
Our results showed that conventional PTK induced a significant hyperopic change, but that hyperopia-correcting PTK (HC-PTK) did not induce a significant change in refraction in such diseased patients
Summary
Phototherapeutic keratectomy (PTK) has been widely acknowledged to be a safe and effective means to remove diseased tissue by the use of excimer laser photoablation in eyes having opaque corneas such as granular corneal dystrophy (GCD) and band-shaped keratopathy (BSK) [1–7]. A hyperopic shift in refraction can occur after PTK surgery due to the flattening of the cornea. Outcomes of Hyperopia-Correcting PTK by laser photoablation, its shift largely depends on the excimer laser system [1, 6–10]. It is one of the ongoing concerns that have to be taken into consideration, especially in eyes undergoing cataract surgery and in eyes requiring unilateral PTK. It is clinically helpful to prevent this hyperopic shift in such patients, in order to maximize unaided vision and patient satisfaction. The present study aims to prospectively compare the clinical outcomes of our devised hyperopia-correcting PTK (HC-PTK) and conventional PTK for GCD and BSK, with special attention to refractive changes
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