Abstract
3/2010
vol. 112
Experimental research
Treatment of post-burn persistent corneal ulcers with excimer laser phototherapeutic keratectomy. Prospective clinical trial
- Department of Eye Burns, Ophthalmic Plastic Surgery, Keratoplasty and Keratoprosthesis, The Filatov Institute of Eye Diseases and Tissue Therapy
- Refractive Laser Centre “Tarus”
Online publish date: 2010/10/12
Purpose: To evaluate efficacy of excimer laser phototherapeutic keratectomy (PTK) in treatment of patients with post-burn persistent corneal ulcers.
Material and methods: Study design – nonrandomized trial with a “historic” control group. 54 eyes (53 patient) with central superficial post-burn corneal ulcers that were formed in different time frame (18-104 days) after grade IV burns were included into
the study. Among these 26 patients (26 eyes) were included prospectively – they underwent 1-time PTK. Control group consists of 27 patients (28 eyes), who underwent surgical keratectomy of ulcer edge and base. Indication for surgery in both groups
was non-decreasing size of ulcer during 7-14 days of conventional treatment. Patients of both groups wore therapeutic contact
lenses after surgery. Outcome measures were number of cases of corneal healing, number of complications, terms of corneal
epithelialization, visual acuity.
Results: PTK promoted corneal healing in 24/26 patients, surgical keratectomy was effective in 27/28 patients. PTK 1) did not
lead to complications (one corneal perforation in control group), 2) accelerated corneal epithelialization on 18,4 days compared
to surgical keratectomy group (p = 0.000, Kruskal-Wallis test), 3) improved mean visual acuity on 0.08 compared to control
group in 6 months follow-up examination (Bonferroni corrected p = 0.002, Kruskal-Wallis test).
Conclusion: PTK is a safe and effective method for treatment of post-burn superficial persistent corneal ulcers recalcitrant to
conventional therapy.
Material and methods: Study design – nonrandomized trial with a “historic” control group. 54 eyes (53 patient) with central superficial post-burn corneal ulcers that were formed in different time frame (18-104 days) after grade IV burns were included into
the study. Among these 26 patients (26 eyes) were included prospectively – they underwent 1-time PTK. Control group consists of 27 patients (28 eyes), who underwent surgical keratectomy of ulcer edge and base. Indication for surgery in both groups
was non-decreasing size of ulcer during 7-14 days of conventional treatment. Patients of both groups wore therapeutic contact
lenses after surgery. Outcome measures were number of cases of corneal healing, number of complications, terms of corneal
epithelialization, visual acuity.
Results: PTK promoted corneal healing in 24/26 patients, surgical keratectomy was effective in 27/28 patients. PTK 1) did not
lead to complications (one corneal perforation in control group), 2) accelerated corneal epithelialization on 18,4 days compared
to surgical keratectomy group (p = 0.000, Kruskal-Wallis test), 3) improved mean visual acuity on 0.08 compared to control
group in 6 months follow-up examination (Bonferroni corrected p = 0.002, Kruskal-Wallis test).
Conclusion: PTK is a safe and effective method for treatment of post-burn superficial persistent corneal ulcers recalcitrant to
conventional therapy.
Keywords
corneal ulcer, eye burn, excimer laser, phototherapeutic keratectomy
Integrated with
