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. 2018 May 14:12:895-901.
doi: 10.2147/OPTH.S161018. eCollection 2018.

"Wet" transepithelial phototherapeutic keratectomy in the management of persistent epithelial defects in the graft

Sergei V Churashov  1 , Elena V Kudryashova  1 , Alexei N Kulikov  1 , Ernest V Boiko  1   2   3 , Valerii F Chernysh  1 , Dmitrii S Maltsev  1
Affiliations

"Wet" transepithelial phototherapeutic keratectomy in the management of persistent epithelial defects in the graft

Sergei V Churashov et al. Clin Ophthalmol. .

Abstract

Purpose: This study aimed to evaluate the efficacy of "wet" transepithelial phototherapeutic keratectomy (TE-PTK) for treating persistent epithelial defects (PEDs) in the corneal graft following penetrating keratoplasty (PKP).

Methods: This study describes a noncomparative, prospective interventional case series. Patients with post-PKP graft epithelial defects lasting >3 months despite previous treatments with extensive wear soft contact lenses, amniotic membrane transplantation, and tarsorrhaphy were treated with wet TE-PTK. A wet TE-PTK procedure including a "wet ablation" step was performed using the EC-5000 excimer laser. Follow-up visits were at post-PTK days 3, 5, 10, and 30, and at each month thereafter.

Results: Eight patients (8 eyes; 5 men and 3 women; mean age, 51.3±14.3 years; mean follow-up period, 9.1±3.0 months) were included in this study. The mean best-corrected visual acuity was 1.76±0.28 log minimum angle of resolution (logMAR) at baseline and improved to 1.1±0.22 logMAR at 10 days postoperatively (p=0.0156; the improvement was significant). This effect remained stable throughout the remainder of the follow-up period. The mean time from wet TE-PTK to complete reepithelization was 4.3±1.3 days.

Conclusion: Wet TE-PTK appears to be effective for patients with post-PKP PEDs in the corneal graft who have failed conservative measures or previous surgical interventions.

Keywords: penetrating keratoplasty; persistent epithelial defects; phototherapeutic keratectomy; recurrent corneal erosion; transepithelial phototherapeutic keratectomy.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Steps of wet transepithelial phototherapeutic keratectomy (TE-PTK) in the management of persistent epithelial defects in the graft. Notes: (A) The surface of the graft was dried, except for the area of erosion. (B) A 50 μm epithelial ablation was performed as the first ablation stage. (C) The surface of erosion was completely dried. (D) The second ablation stage was performed up to a depth of 10 μm. (E) The ablation was stopped when a uniform and smooth anterior stromal surface was visualized in laser spot projection.
Figure 2
Figure 2
Graft surface prior to and following wet transepithelial phototherapeutic keratectomy for persistent epithelial defects in the graft in patient number 8. Abbreviation: PreOP, preoperative.
See this image and copyright information in PMC

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