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“Wet” transepithelial phototherapeutic keratectomy in the management of persistent epithelial defects in the graft

Authors Churashov SV, Kudryashova EV, Kulikov AN, Boiko EV, Chernysh VF, Maltsev DS

Received 28 December 2017

Accepted for publication 22 March 2018

Published 14 May 2018 Volume 2018:12 Pages 895—901


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Sergei V Churashov,1 Elena V Kudryashova,1 Alexei N Kulikov,1 Ernest V Boiko,1–3 Valerii F Chernysh,1 Dmitrii S Maltsev1

1Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia; 2St Petersburg Branch, The S Fyodorov Eye Microsurgery Federal State Institution, St Petersburg, Russia; 3Department of Ophthalmology, Mechnikov North-Western State Medical University, St Petersburg, Russia

Purpose: This study aimed to evaluate the efficacy of “wet” transepithelial phototherapeutic keratectomy (TE-PTK) for treating persistent epithelial defects (PEDs) in the corneal graft following penetrating keratoplasty (PKP).
Methods: This study describes a noncomparative, prospective interventional case series. Patients with post-PKP graft epithelial defects lasting >3 months despite previous treatments with extensive wear soft contact lenses, amniotic membrane transplantation, and tarsorrhaphy were treated with wet TE-PTK. A wet TE-PTK procedure including a “wet ablation” step was performed using the EC-5000 excimer laser. Follow-up visits were at post-PTK days 3, 5, 10, and 30, and at each month thereafter.
Results: Eight patients (8 eyes; 5 men and 3 women; mean age, 51.3±14.3 years; mean follow-up period, 9.1±3.0 months) were included in this study. The mean best-corrected visual acuity was 1.76±0.28 log minimum angle of resolution (logMAR) at baseline and improved to 1.1±0.22 logMAR at 10 days postoperatively (p=0.0156; the improvement was significant). This effect remained stable throughout the remainder of the follow-up period. The mean time from wet TE-PTK to complete reepithelization was 4.3±1.3 days.
Conclusion: Wet TE-PTK appears to be effective for patients with post-PKP PEDs in the corneal graft who have failed conservative measures or previous surgical interventions.

Keywords: phototherapeutic keratectomy, persistent epithelial defects, penetrating keratoplasty, transepithelial phototherapeutic keratectomy, recurrent corneal erosion

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