Transepithelial phototherapeutic keratectomy for treatment-resistant recurrent corneal erosion syndrome
© 2024. The Author(s)..
BACKGROUND: To evaluate the efficacy and safety of trans-epithelial phototherapeutic keratectomy (TE-PTK) as a treatment for recurrent corneal erosion syndrome (RCES) in patients with symptoms refractory to conventional treatments.
METHODS: All patients who received TE-PTK treatment for RCES had failed 3 or more conventional treatments and were reviewed, and if met criteria, approved by healthcare workers of the British Columbia public health authority (Medical Services Plan (MSP). A retrospective chart review and telephone survey were conducted at the Pacific Laser Eye Centre (PLEC). Exclusion criteria were ocular co-morbidities potentially affecting treatment efficacy.
RESULTS: This study included 593 eyes of 555 patients (46.2% male; 50.9 ± 14.2 years old) who underwent TE-PTK. The leading identified causes of RCES were trauma (45.7%) and anterior basement membrane dystrophy (44.2%). The most common pre-PTK interventions were ocular lubricants (90.9%), hypertonic solutions (77.9%), and bandage contact lenses (50.9%). Thirty-six eyes had undergone surgical interventions such as stromal puncture, epithelial debridement, or diamond burr polishing. Post-PTK, 78% of patients did not require any subsequent therapies and 20% required ongoing drops. Six patients (1.1%) reported no symptom improvement and required repeat TE-PTK for ongoing RCES symptoms after initial TE-PTK. All 6 eyes were successfully retreated with TE-PTK (average time to retreatment was 11.3 ± 14.9 months). There was no significant difference in best corrected visual acuity pre- vs. post-operatively. The mean post-operative follow-up was 60.5 months (range: 5-127 months).
CONCLUSION: TE-PTK has a good efficacy and safety profile for treatment-resistant RCES. The third-party public health-reviewed nature of this study, the low recurrence rate of RCES, and the low PTK retreatment rate suggest that TE-PTK might be considered for wider use in the management of RCES.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie - (2024) vom: 15. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bizrah, Mukhtar [VerfasserIn] |
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| Links: |
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| Themen: |
Anterior basement membrane dystrophy (ABMD) |
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| Anmerkungen: |
Date Revised 15.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s00417-024-06482-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM371089336 |
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| 245 | 1 | 0 | |a Transepithelial phototherapeutic keratectomy for treatment-resistant recurrent corneal erosion syndrome |
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| 520 | |a © 2024. The Author(s). | ||
| 520 | |a BACKGROUND: To evaluate the efficacy and safety of trans-epithelial phototherapeutic keratectomy (TE-PTK) as a treatment for recurrent corneal erosion syndrome (RCES) in patients with symptoms refractory to conventional treatments | ||
| 520 | |a METHODS: All patients who received TE-PTK treatment for RCES had failed 3 or more conventional treatments and were reviewed, and if met criteria, approved by healthcare workers of the British Columbia public health authority (Medical Services Plan (MSP). A retrospective chart review and telephone survey were conducted at the Pacific Laser Eye Centre (PLEC). Exclusion criteria were ocular co-morbidities potentially affecting treatment efficacy | ||
| 520 | |a RESULTS: This study included 593 eyes of 555 patients (46.2% male; 50.9 ± 14.2 years old) who underwent TE-PTK. The leading identified causes of RCES were trauma (45.7%) and anterior basement membrane dystrophy (44.2%). The most common pre-PTK interventions were ocular lubricants (90.9%), hypertonic solutions (77.9%), and bandage contact lenses (50.9%). Thirty-six eyes had undergone surgical interventions such as stromal puncture, epithelial debridement, or diamond burr polishing. Post-PTK, 78% of patients did not require any subsequent therapies and 20% required ongoing drops. Six patients (1.1%) reported no symptom improvement and required repeat TE-PTK for ongoing RCES symptoms after initial TE-PTK. All 6 eyes were successfully retreated with TE-PTK (average time to retreatment was 11.3 ± 14.9 months). There was no significant difference in best corrected visual acuity pre- vs. post-operatively. The mean post-operative follow-up was 60.5 months (range: 5-127 months) | ||
| 520 | |a CONCLUSION: TE-PTK has a good efficacy and safety profile for treatment-resistant RCES. The third-party public health-reviewed nature of this study, the low recurrence rate of RCES, and the low PTK retreatment rate suggest that TE-PTK might be considered for wider use in the management of RCES | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Anterior basement membrane dystrophy (ABMD) | |
| 650 | 4 | |a Corneal erosion | |
| 650 | 4 | |a Epithelial debridement | |
| 650 | 4 | |a Phototherapeutic keratectomy (PTK) | |
| 650 | 4 | |a Recurrent corneal erosion syndrome (RCES) | |
| 650 | 4 | |a Transepithelial PTK | |
| 700 | 1 | |a Shunmugam, Maheshver |e verfasserin |4 aut | |
| 700 | 1 | |a Ching, Geoffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Radhika P |e verfasserin |4 aut | |
| 700 | 1 | |a Din, Nizar |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, David T C |e verfasserin |4 aut | |
| 700 | 1 | |a Holland, Simon P |e verfasserin |4 aut | |
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