Journal of the Korean Ophthalmological Society 2005;46(11):1765-1773.
Published online November 30, 2005.
Clinical Effects of Phototherapeutic Keratectomy on Terminal Bullous Keratopathy.
Chung Hyun Lee, Jun Her
Department of Ophthalmology, InJe University College of Medicine Busan Paik Hospital, Busan, Korea. hereye@inje.ac.kr
레이저각막절제술을 이용한 말기 수포각막병증의 치료
이충현,허준
Department of Ophthalmology, InJe University College of Medicine Busan Paik Hospital, Busan, Korea
Correspondence:  Chung-Hyun Lee, M.D.
Abstract
PURPOSE
Although the treatment of choice for bullous keratopathy is typically penetrating keratoplasty (PKP), not all patients are suited for this treatment. Thus, we evaluated the clinical effects of phototherapeutic keratectomy (PTK) on pain relief and on the improvement of photophobia and visual acuity in patients suffering from bullous keratopathy. METHODS: Twenty-three patients with bullous keratopathy who were awaiting PKP and suffering from ocular pain, photophobia, and cosmetic problems, were assessed. Twelve eyes were treated with PTK using the excimer laser (VISX STAR S3, Irvine, CA, U.S.A). Another 11 eyes were treated with eye drops or other conservative modalities. Statistically significant differences in pain relief, photophobia improvement, and cosmetic improvement between two groups were assessed by Fisher's exact test. RESULTS: Twelve eyes with bullous keratopathy underwent PTK. At post-operative 1 month, 83% of patients showed relief of pain, 75% of patients showed improvements in photophobia, and 58% of patients had increased visual acuity of one or more line. The overall satisfaction rate of PTK was 91%, but 67% of patients showed recurrence of corneal opacity and bullae formation at 6 months after the procedure. CONCLUSIONS: Phototherapeutic keratectomy (PTK) reduced pain and improved visual acuity slightly in patients with bullous keratopathy. This procedure could be considered a valuable alternative treatment modality while awaitng PKP.
Key Words: Bullous keratopathy;Keratoplasty;Phototherapeutic keratectomy (PTK);Pseudophakic bullous keratopathy


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