Phototherapeutic keratectomy for anterior basement membrane dystrophy after laser in situ keratomileusis

Abstract

Objective: To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) in the treatment of symptomatic anterior basement membrane dystrophy following laser in situ keratomileusis (LASIK). Methods: In a retrospective study, 10 eyes of 10 patients that developed symptomatic anterior basement membrane dystrophy following LASIK for myopia were treated with PTK using the VISX S2 (VISX Inc, Santa Clara, Calif) excimer laser. Primary outcome measurements including corneal clarity, resolution of symptoms, uncorrected visual acuity (UCVA), manifest refraction, best spectacle-corrected visual acuity (BSCVA), and complications were evaluated preoperatively, 1 day postoperatively, and at the last postoperative follow-up visit. Results: At the last follow-up visit (mean [SD], 8.8 [5.5] months; range, 4-22 months), 100% of the eyes had clear corneas with no evidence of anterior basement membrane dystrophy, and all eyes were asymptomatic. Mean spherical equivalent changed from -0.75 (0.99) diopters (D) (range, -2.75 to +0.25 D) preoperatively to -0.51 (0.80) D (range, -1.63 to +1.00 D) at the last follow-up visit (P=.64). Uncorrected visual acuity improved from 20/20 or better in 1 eye (10%) and 20/40 or better in 5 eyes (50%) preoperatively to 20/20 or better in 5 eyes (50%) and 20/40 or better in 7 eyes (70%) postoperatively. No eyes lost lines of BSCVA, 2 eyes gained 1 line, 2 eyes gained 2 lines, and 1 eye gained 4 lines. There was a statistically significant improvement in mean logMAR BSCVA postoperatively, improving from 0.06 (0.16) (range,-0.1 to +0.3) to-0.08 (0.07) (range,-0.1 to +0.1) (P=.04). Postoperative complications included diffuse lamellar keratitis that resolved after treatment without sequelae (20%) and induced myopia exceeding -1.50 D (10%). Conclusion: Phototherapeutic keratectomy for the treatment of symptomatic anterior basement membrane dystrophy following LASIK treatment is safe and effective.