Phototherapeutic Keratectomy for the Treatment of Persistent Epithelial Defect

Abstract

Persistent epithelial defect (PED) is an important ocular surfacedisorder. These defects can be frustrating in chronic diseases, as inthe case of inflammation, chemical burn, denervated cornea, teardeficiency, and radiation keratitis. Therapeutic modalities that havebeen utilized in the treatment of FED include topical steroid, patching,bandage soft contact lenses, superficial keratectomy, and anteriorstromal puncture. This report evaluates the use of 193 nm excimer laser(PTK) for the treatment of indolent and persistent epithelial defect asa new therapeutic device for FED.Twelve eyes diagnosed with FED were treated with Summit excimer laserphototherapeutic keratectomy. All cases had failed to cover theepithelium with the use of therapeutic contact lenses. Laser treatmentwas delivered to sites surrounding the epithelial defect area to promoteepithelial ingrowth.All eyes receiving PTK were covered with new epithelium in two or threedays as shown by photo refractive keratectomy and remained completelyhealed for at least three months of follow-up.This study finds PTK with the 193 nm excimer laser to be a safe,effective treatment for FED that is unresponsive to conventionaltherapy.