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  Česky / Czech version Čs. Oftal., 58, 2002, No. 2, p. 105-111
 
Phototherapeutic Keratectomy in the Management of Anterior Corneal Disorders in Children 
Autrata R., Řehůřek J., Holoušová M. 

Dětská oční klinika DN FNB a LF MU, Brno, přednosta prof. MUDr. J. Řehůřek, CSc.
 


Summary:

       Retrospective clinical trial evaluated efficacy and safety of phototherapeutic keratectomy(PTK) within35children(35 eyes) aged8 to 18years (mean12,6years). All children hada long timepostoperative follow-up rangedfrom2 to5 years (mean 3,2 years). Indications for PTK in children were: recurrent corneal epithelial erosion syn- drom, 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. Phototerapeutic 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, bandkeratopathy, dry spots, mucous plaques, anterior corneal dystrophies, and anterior post-keratitis and post-traumatic scars.

        Key words: phototherapeutic keratectomy, excimer laser, children
       

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