Excimer laser phototherapeutic keratectomy for the treatment of silicone oil-induced band-shaped keratopathy.

摘要

PURPOSE: To study the efficacy of excimer laser phototherapeutic keratectomy (PTK) for the treatment of band-shaped keratopathy (BSK). METHODS: A retrospective analysis of case records of 20 eyes of 20 patients with silicone oil-induced BSK and significant media haze that underwent PTK was conducted. Improvement in corneal clarity and best-corrected visual acuity (BCVA) was assessed at 6 weeks postoperatively. RESULTS: The mean ablation depth was 62.63+/-23.82 mum (range 25 to 100 mum). Postoperative course was uneventful, and the mean time for healing of the epithelial defect was 4.25+/-2.43 days. All the eyes showed significant improvement in corneal clarity at 6 weeks postoperatively. The mean score of corneal clarity increased from 1.15+/-0.74 preoperatively to 3.35+/-0.49 at 6 weeks postoperatively (P<0.001). At postoperative 6 weeks, 90% (18 eyes) showed an improvement in BCVA of 2 or more lines, whereas the BCVA remained unchanged in two eyes (10%). There was a hyperopic shift postoperatively with a mean shift of spherical equivalent of 2.23+/-2.08 D. At the end of the last follow-up (mean: 16.75+/-4.2 months; range 11-24 months), two eyes with silicone oil in the vitreous chamber and with inferior peripheral and shallow retinal detachment showed recurrence of BSK for which retreatment with PTK was given. CONCLUSIONS: Phototherapeutic keratectomy is an effective option for the treatment of silicone oil-induced BSK with significant improvement in corneal clarity. However, the gain in visual acuity depends on the coincident posterior segment pathologic condition. Further, in eyes with retained silicone oil, there is a risk of recurrence of BSK for which retreatment may be required.