Excimer laser phototherapeutic keratectomy for recurrent pterygium.

PURPOSE: To analyze the results of excimer laser phototherapeutic keratectomy (PTK) combined with simple excision in recurrent pterygium to minimize the recurrence rate and obtain a smooth corneal surface. SETTING: Veni Vidi Eye Health Centre, Istanbul, Turkey. METHODS: Combined pterygium excision and excimer laser PTK was performed in 22 eyes with recurrent pterygium (22 patients). Both spot and scan modes of the Meditec MEL 60 excimer laser were used to produce a wide ablation layer (depth 40 to 80 microns). RESULTS: During the mean follow-up of 16.5 months (range 6 to 27 months), visual acuity, refraction, slitlamp, and corneal topography examinations were recorded. Pterygium recurred in only 1 eye (4.5%). Postoperative visual acuity improved in 15 eyes (68.2%). Keratometric readings were not accurately measured preoperatively because of corneal surface irregularities but could be easily taken after the surgery. Corneal astigmatism ranged from 0 to 2.00 diopters (D) (mean 1.23 D). Three months after surgery, no haze persisted in any eye. No significant intraoperative or postoperative complication was detected. CONCLUSIONS: Excimer laser PTK appears to simplify pterygium surgery because a superficial keratectomy is sufficient to remove pterygium. The excimer laser can be used to ablate the visible residual tissues and smooth the corneal surface, resulting in good postoperative refraction and visual acuity. Consequently, this procedure seems to be effective and safe.

Excimer laser photorefractive keratectomy (PRK) in myopic astigmatism.

UNLABELLED: To assess the visual and refractive results of excimer laser photorefractive keratectomy (PRK) in myopic astigmatism. METHODS: Excimer laser PRK was performed using an Aesculap Meditec MEL 60 laser in 46 myopic astigmatic eyes. Preoperative corneal astigmatism was -1.50 D. (+/- 0.50) in 7 eyes (15.2%); -2.50 D. (+/- 0.50 in 14 eyes (30.5%); -3.50 D. (+/- 0.50) in 13 eyes (28.3%); -4.50 D. (+/- 0.50) in 8 eyes (17.4%); and -5.50 D. (+/- 0.50) in 4 eyes (8.6%). Mean preoperative cylinder was -3.50 D. (+/- 2.50). Mean preoperative sphere was -4.50 D. (+/- 2.25). Pre and post-operative visual acuity, refraction, keratometer readings, corneal topography, intraocular pressure, and slit lamp findings were recorded. RESULTS: By one year of follow-up, postoperative cylinder was between +0.50 and -0.50 D. in 31 eyes (67.4%); between -0.50 and -1.50 D. in 11 eyes (23.9%); between -1.50 and -2.50 D. in 4 eyes (8.7%). Mean post-operative cylinder was -1.21 D. (+/- 1.70). Mean postoperative sphere was -1.09 D. (+/- 1.25). Myopic and astigmatic improvement was achieved in each patient (100%). Topography analysis showed 69.4% were within 0.5 mm, 96.8% within 1 mm, 97.8% within 1.5 mm of centration; 55% of the patients achieved uncorrected visual acuity of 10/10 (Snellen). One patient (2.2%) lost one line of best corrected vision due to decentration and change of axis. CONCLUSION: These preliminary results of myopic astigmatic excimer laser PRK procedures compare favorably in efficiency and safety with reports of PRK for myopia.