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Phototherapeutic keratectomy re-treatment for recurrent corneal erosion syndrome

¹ Corneal Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
² Centre for Eye Research Australia, Melbourne, Australia

Correspondence to:
Correspondence to:
Dr Michael S Loughnan, Corneal Unit, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne 3002, Victoria, Australia

ABSTRACT
Aims: Phototherapeutic keratectomy with an excimer laser is commonly used to treat recurrent corneal erosion syndrome. The aim of this study was to determine the success of a repeat phototherapeutic keratectomy for patients with persistent macroerosions following initial treatment with phototherapeutic keratectomy.

Methods: Eight patients who failed primary phototherapeutic keratectomy for recurrent corneal erosion syndrome were treated with repeat phototherapeutic keratectomy. All patients were treated with a superficial therapeutic ablation profile with a Visx, Nidek, or Summit 193 nm excimer laser. All patients were treated for both their primary treatment and re-treatment by the same surgeon. Retrospective analysis of case records of all patients requiring re-treatment was supplemented with a telephone interview.

Results: Over a 5 year period (October 1995 to October 2000) 76 eyes were treated for recurrent erosion syndrome with phototherapeutic keratectomy. All patients had documented macroerosions and had failed previous treatment with a lubricant at night. Eight eyes (11%) continued to have macroerosions after this initial treatment; all opted for re-treatment with phototherapeutic keratectomy. Following re-treatment none reported symptoms consistent with a macroerosion. Six of eight patients (75%) are now symptom free; 2/8 (25%) have an occasional foreign body sensation relieved by lubricants. Follow up ranged from 9–60 months with a mean of 25.5 months.

Conclusion: Re-treatment with phototherapeutic keratectomy appears to be successful for patients with macroerosions complicating recurrent corneal erosion syndrome who have failed conservative management with ocular lubricants and a primary phototherapeutic keratectomy.

Keywords: excimer; cornea; erosion

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