A new meta-analysis published in Ophthalmic Research evaluated the use of phototherapeutic keratectomy (PTK) as a treatment option for recurrent corneal erosions (RCE).
Give me some background first.
Conservative treatments for RCE, such as topical lubrication, hypertonic agents, and bandage soft contact lenses, can be effective for recurrent erosion.
However, despite conservative treatment, a large proportion of patients continue to have minor and major recurrences.
How does PTK come into play?
PTK has been a useful tool in treating RCE because it ablates corneal tissue with extremely high precision and minimal adjacent tissue damage.
And the goal of this study?
This study aimed to more precisely estimate the success rate, efficacy, and safety of PTK treatment in patients with RCE of different etiologies.
Now the details.
Investigators examined 21 studies—including four controlled experiments and 17 single-arm experiments—comprising 642 patients (705 eyes) with RCEs who underwent PTK.
Pre-PTK, the recurrence rate of RCE among all studies ranged from 0 to 41%; follow-up time was between 3 months and 14 years.
Most of these patients had a history of more than three symptomatic episodes of RCE despite conventional treatments, such as artificial lubricants, patching, epithelial debridement, and therapeutic contact lenses.
What did they find?
A total of 571 patients showed complete resolution of RCE symptoms after PTK, with follow-up time ranging from 9 months to 12 years.
And the recurrence rate?
Subgroup analysis showed a recurrence rate of 17% post-traumatic RCE, and 22% in the patient group with corneal dystrophy.
Compared to patients with a traumatic cause of epithelial erosions, the likelihood to experience a recurrence was higher in patients with corneal dystrophy.
The take home.
Per the study authors, PTK was found to be suitable for patients who have not responded to conventional treatments like topical medications, bandage contact lenses, epithelial debridement, and even superficial stromal puncture.
“Therefore we recommend considering PTK if patients have undergone conventional treatments but continued to experience more than three episodes of RCE,” they concluded.