Treatment of band keratopathy by excimer laser phototherapeutic keratectomy: Surgical techniques and long term follow up

A series of 122 eyes with band keratopathy was treated by excimer laser phototherapeutic keratectomy (PTK), with a mean foliow up of over 12*3 months (range 3 to 60 months). A single photoablation zone was used to remove the opacity over the visual axis in smooth surfaced band deposition. In eyes with reduced vision, an improvement was reported in 88% and in a series of 66 eyes mean Snelien visual acuity increased significantly (p<005, t=2-27). A reduction in glare was reported in 88% and in a series of 17 patients, visual contrast sensitivity (p<001) and measurements of disability glare (p<001) improved postoperatively. The mean hyperopic shift in 32 eyes at 6 months was 1.4 D (range 0-4-25 D). Multiple overlapping ablation zones, with mechanical debulking of large calcium plaques, were used to smooth the irregular corneal surface in eyes with rough bands. Ocular discomfort was improved in 95%. Band keratopathy recurred in nine eyes (8%) within 2 to 30 months (mean 12 months) of surgery, with silicone oil responsible in five eyes. Reablation was necessary in three eyes and performed successfuliy in all cases. Excimer laser PTK is a safe and effective outpatient treatment for band keratopathy.