PHOTOTHERAPEUTIC KERATECTOMY AS PRIMARY OPTION BEFORE PENETRATING KERATOPLASTY

Background Argon fluoride excimer laser (193-nm) can perform precise corneal ablation with submicron accuracy and minimal reaction to the adjacent tissue. A possible application is anterior lamellar keratectomy to remove superficial corneal opacities and to smooth corneal irregularities. Patients and methods Between August 1993 and June 1994 we performed a phototherapeutic keratectomy (PTK) in 35 patients with different corneal diseases by excimer laser (Aesculap-Meditec). 3 cases (2 corneal dystrophies and 1 patient with a traumatic corneal opacity after chemical burn) are described more exactly with operative methods and postoperative results. Results By slitlamp microscopy we observed an improvement of the primary corneal disorder in all cases. Changing of refraction (hyperopic shift and newly formed astigmatism) arose in 2 out of 3 patients. Conclusions Phototherapeutic keratectomy by excimer laser represents a secure, less invasive alternative to surgical methods promising quicker visual recovery. Often a penetrating keratoplasty can be avoided or delayed.