Refractive-Neutral Phototherapeutic Keratectomy for Management of Anterior Corneal Dystrophies With Coexisting Refractive Errors

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Tushar Agarwal, MD, All India Institute of Medical Sciences, New Delhi, India
Srilathaa Gunasekaran, MD, All India Institute of Medical Sciences, New Delhi, India
Namrata Sharma, MD, All India Institute of Medical Sciences, New Delhi, India

Narrative Responses:

Purpose
To evaluate the outcomes of Refractive-neutral phototherapeutic keratectomy for management of anterior corneal dystrophies with co-existing refractive errors.

Methods
We conducted a retrospective chart review of 11 eyes (8 patients) with anterior corneal dystrophies (4 eyes – granular dystrophy, 4 eyes – Reis Buckler dystrophy, 3 eyes – Thiel-Behnke dystrophy) and co-existing refractive errors. The effect of PTK was achieved by performing photo refractive keratectomy (PRK) according to the respective refractive error in each eye. This functioned as Refractive neutral PTK (RnPTK) as it cleared the corneal opacity and also simultaneously corrected the refractive error. The main outcome measures were Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA ) at 1 month of follow-up.

Results
Pre-operative UCVA, BCVA, Mean Refractive Spherical Equivalent (MRSE), astigmatism, were 0.73 ± 0.38  (logMAR ) , 0.39 ± 0.14 (logMAR ), 1.86 ± 4.62 D , -0.91 ± 1.83 D,  559.6 ±61.55 microns respectively. The mean logMAR UCVA and BCVA were 0.49 ± 0.46 and 0.23 ± 0.16 at 1 month of follow-up. There were no significant intraoperative / postoperative complications in any of the patients

Conclusion
RnPTK can be a viable treatment modality for patients of anterior corneal dystrophies with co-existing refractive errors as it clears visual axis and corrects the refractive error in a single sitting.