Phototherapeutic Keratectomy in Treatment of Anterior Basement Membrane Dystrophy: Cross-Sectional Study
Narrative Responses:
Purpose
Our purpose is to describe patient-reported data demonstrating the long-term effectiveness of phototherapeutic keratectomy (PTK) on the symptoms experienced by patients with anterior basement membrane dystrophy (ABMD), and correlate different laser settings used with treatment success.
Methods
All patients who were treated with PTK between 2005 and 2011 for symptoms including painful recurrent corneal erosions or visual compromise at the University of Ottawa Eye Institute were sent a questionnaire that requested information on pre- and post-operative symptoms and treatments as well as current status. All patients who returned the questionnaire and had ABMD documented in their charts were included. Data was collected from the questionnaire, follow-up phone call, and hospital records. Success of treatment was defined as control or cure of symptoms experienced.
Results
Seventy-two patients met the inclusion criteria and completed the questionnaire. Pre-PTK, symptoms included blurred vision only in 36%, pain only in 28% and both blurred vision and pain in 36%. The procedure yielded an 89% success rate with an 11% failure rate, requiring repeat PTK. Patients treated with 8Hz had significantly greater treatment success than 6Hz, 90% compared to 78% respectively (p < 0.05). Moreover, treatment with a 16um ablation depth had significantly greater treatment success than treatment of a 12um depth, 89% compared to 84% respectively (p<0.05). Ninety-five percent of recurrences occurred within the first twelve months after treatment.
Conclusion
Only four small studies have looked at the recurrence of erosions in PTK-treated ABMD patients. These studies quote incidence rates ranging from 0-42%. Our study shows an 89% success rate, with approximately 11% of patients experiencing recurrences, which required repeat laser treatment at a mean of 29 months post-operatively.