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Phototherapeutic Keratectomy for Anterior Basement Membrane Dystrophy After Laser In Situ Keratomileusis
Maria C. Rojas, MD;
Edward E. Manche, MD
Arch Ophthalmol. 2002;120:722-727.
Objective To evaluate the efficacy and safety of phototherapeutic keratectomy
(PTK) in the treatment of symptomatic anterior basement membrane dystrophy
following laser in situ keratomileusis (LASIK).
Methods In a retrospective study, 10 eyes of 10 patients that developed symptomatic
anterior basement membrane dystrophy following LASIK for myopia were treated
with PTK using the VISX S2 (VISX Inc, Santa Clara, Calif) excimer laser. Primary
outcome measurements including corneal clarity, resolution of symptoms, uncorrected
visual acuity (UCVA), manifest refraction, best spectacle–corrected
visual acuity (BSCVA), and complications were evaluated preoperatively, 1
day postoperatively, and at the last postoperative follow-up visit.
Results At the last follow-up visit (mean [SD], 8.8 [5.5] months; range, 4-22
months), 100% of the eyes had clear corneas with no evidence of anterior basement
membrane dystrophy, and all eyes were asymptomatic. Mean spherical equivalent
changed from -0.75 (0.99) diopters (D) (range, -2.75 to +0.25
D) preoperatively to -0.51 (0.80) D (range, -1.63 to +1.00 D)
at the last follow-up visit (P = .64). Uncorrected
visual acuity improved from 20/20 or better in 1 eye (10%) and 20/40 or better
in 5 eyes (50%) preoperatively to 20/20 or better in 5 eyes (50%) and 20/40
or better in 7 eyes (70%) postoperatively. No eyes lost lines of BSCVA, 2
eyes gained 1 line, 2 eyes gained 2 lines, and 1 eye gained 4 lines. There
was a statistically significant improvement in mean logMAR BSCVA postoperatively,
improving from 0.06 (0.16) (range, -0.1 to +0.3) to -0.08 (0.07)
(range, -0.1 to +0.1) (P = .04). Postoperative
complications included diffuse lamellar keratitis that resolved after treatment
without sequelae (20%) and induced myopia exceeding -1.50 D (10%).
Conclusion Phototherapeutic keratectomy for the treatment of symptomatic anterior
basement membrane dystrophy following LASIK treatment is safe and effective.
From the Department of Ophthalmology, Stanford University School of
Medicine, Stanford, Calif. The authors have no proprietary interest in the
instruments or techniques described in this article.
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