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[Phototherapeutic keratectomy in the treatment of corneal surface disorders in children]

R Autrata, J Rehůrek, M Holousová
Ceská a Slovenská Oftalmologie 2002, 58 (2): 105-11
Retrospective clinical trial evaluated efficacy and safety of phototherapeutic keratectomy (PTK) within 35 children (35 eyes) aged 8 to 18 years (mean 12.6 years). All children had a long time postoperative follow-up ranged from 2 to 5 years (mean 3.2 years). Indications for PTK in children were: recurrent corneal epithelial erosion syndrome, superficial scars after keratitis "e lagophthalmo", dry spots and mucous plaques after atopic- vernal eye disease, band keratopathy, anterior corneal dystrophies, corneal scars secondary to post-infectious keratitis (post-herpes simplex corneal scarring) and following trauma. The aim of treatment were to improve visual acuity and to reduce or eliminate subjective ocular discomfort-pain, lacrimation and photophobia. Fully informed parents consent was done at all cases. There was increased the best spectacle corrected visual acuity (BSCVA) in all Children, and episodes of ocular pain, lacrimation and photophobia diminished. The mean preoperative BSCVA 6/36 (ranged from 6/9 to 1/60) improved to mean value 6/12 (ranged from 6/6 to 6/60) as 2-5 years follow-up postoperatively. Seven children had 5 or more Snellen's lines gain of the BSCVA, ten children gained 4 lines, eight children gained 3 lines and five children gained 2 lines postoperatively in comparison to their preoperative values. At four cases were evaluated only 1 line gain of BSCVA, one eye unchanged, and no eye had BSCVA worsened after PTK. Phototherapeutic keratectomy in children seems to be an effective and safety procedure in the management of suitable anterior corneal disorders. Our clinical results suggest the most suitable diagnoses for treatment include recurrent corneal epithelial erosions, band keratopathy, dry spots, mucous plaques, anterior corneal dystrophies, and anterior post-keratitis and post-traumatic scars.

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