RESUMEN
PURPOSE: We report a case of keratolysis following phototherapeutic keratectomy (PTK) for a subepithelial nodule in a patient with keratoconus. METHODS: A 29-year-old male with keratoconus who became contact lens intolerant because of a raised subepithelial nodule was treated with excimer laser phototherapeutic keratectomy (PTK). RESULTS: The epithelium failed to heal postoperatively, and progressive keratolysis led to a central descemetocele by the eighth postoperative day. The patient was managed with a penetrating keratoplasty. CONCLUSIONS: Excimer laser phototherapeutic keratectomy has been shown to be an effective treatment for subepithelial nodules in patients with keratoconus. Rapidly progressive keratolysis is a potential complication of this procedure.
Asunto(s)
Enfermedades de la Córnea/etiología , Lámina Limitante Posterior/patología , Queratocono/cirugía , Queratectomía Fotorrefractiva/efectos adversos , Complicaciones Posoperatorias , Adulto , Enfermedades de la Córnea/patología , Enfermedades de la Córnea/cirugía , Humanos , Hipertrofia , Queratoplastia Penetrante , Láseres de Excímeros , MasculinoRESUMEN
PURPOSE: To review the major advances in the field of refractive surgery occurring over the past 25 years. METHODS: Literature review. RESULTS: The major developments in refractive surgery over the past 25 years are reviewed. CONCLUSIONS: The past 25 years have witnessed great changes in refractive surgery. As a result of advancements in technology, instrumentation, and technique, we have seen improvements in the treatment of all types of ametropias. In this article, we review some of the successes and failures of the past quarter-century.