Phototherapeutic Keratectomy in the Management of Anterior Corneal Disordersin Children

Summary

Retrospective clinical trial evaluated efficacy and safety of phototherapeutickeratectomy(PTK) within35children(35 eyes) aged8 to 18years (mean12,6years).All children hada long timepostoperative follow-up rangedfrom2 to5 years (mean3,2 years).Indications for PTK in children were: recurrent corneal epithelial erosion syn-drom, superficial scars after keratitis „e lagophthalmo“, dry spots and mucousplaques after atopic- vernal eye disease, band keratopathy, anterior cornealdystrophies, corneal scars secondary to post-infectious keratitis (post-herpessimplex corneal scarring) and following trauma. The aim of treatment were toimprove visual acuity and to reduce or eliminate subjective ocular discomfort -pain, lacrimation and photophobia. Fully informed parents consent was done atall cases.There was increased the best spectacle corrected visual acuity (BSCVA) in allchildren, and episodes of ocular pain, lacrimation and photophobia diminished.The mean preoperative BSCVA 6/36 (ranged from 6/9 to 1/60) improved to meanvalue 6/12 (ranged from 6/6 to 6/60) as 2 - 5 years follow-up postoperatively.Seven children had 5 or more Snellen’s lines gain of the BSCVA, ten children gained4 lines, eight children gained 3 lines and five children gained 2 lines postoperativelyin comparison to their preoperative values. At four cases were evaluated only 1 linegain of BSCVA, one eye unchanged, and no eye had BSCVA worsened after PTK.Phototerapeutic keratectomy in children seems to be an effective and safetyprocedure in the management of suitable anterior corneal disorders. Our clinical results suggest the most suitable diagnoses for treatment include recurrentcorneal epithelial erosions, bandkeratopathy, dry spots, mucous plaques, anteriorcorneal dystrophies, and anterior post-keratitis and post-traumatic scars.

Key words:
phototherapeutic keratectomy, excimer laser, children