Overview | Suitability | Procedure | Recovery | Benefits | Video FAQs | FAQs
What is photo-therapeutic keratectomy?
Photo-Therapeutic Keratectomy is a type of laser surgery used to treat corneal conditions or injuries affecting the cornea’s outer surface layer (epithelium). The laser we use is similar to the one we use for vision correction. However, we use PTK to treat painful erosions or abnormalities instead of correcting vision.
To determine if this procedure is necessary, our ophthalmologist may perform an eye examination and several other investigations, depending on the cause. These include corneal topography, ocular coherence tomography (OCT), anterior segment OCT, and full refraction.
Why would I need PTK?
People with corneal dystrophy, scarring, or conditions such as recurrent corneal erosion may need PTK. In these conditions, the corneal epithelium is loose and starts to separate from the rest of the cornea. We often recommend topical treatments before surgical procedures.
Other conditions it may help with include:
- Bullous keratopathy
- Spheroidal degeneration
- Calcium band keratopathy
- Salzmann nodular degeneration
You may also need it before other surgeries, such as cataract surgery, pterygium surgery or keratoplasty. In some cases, it is a less invasive alternative to corneal keratoplasty and can be more effective.
Recurrent corneal erosion (RCE)
RCE occurs when the corneal epithelium is weakened from previous trauma or due to underlying corneal disease. The eyes are frequently painful as this surface layer breaks down, due to this weakness. When medical therapy is ineffective at controlling these episodes, we recommend PTK. It improves the adhesion of the epithelium to the underlying corneal layers and reduces the frequent recurrences experienced in this condition.
Corneal scars and opacities
Scarring from previous trauma or infection and opacities from underlying corneal disease can affect your vision. We can use this treatment to remove scars and opacities in the cornea’s surface layer, improving your vision. We can also use it to reduce the haloes and glare experienced with corneal dystrophies, such as granular corneal dystrophy.
Procedure
Before we begin, we apply a topical or local anaesthetic to prevent pain. During PTK, we use an alcohol solution or the excimer laser to remove a thin layer of corneal epithelium to uncover healthy tissue.
Then, we take out thin layers of corneal tissue until you have a smooth corneal surface. We may need to use a masking fluid to highlight areas that require further ablation and help smooth the cornea.
After this, we use a slit lamp to check if we have removed enough tissue. Once we are satisfied with the results, we place a bandage contact lens over your eye. The bandage contact lens allows your eye to heal more comfortably and limits post-operative pain.
Recovery
As your eye heals, you will need to use antibiotic eye drops to prevent infection, as well as lubricating eye drops and ointment. You may need to use these for up to a month after the procedure. Our ophthalmologist, Mr Tariq Ayoub, will teach you how to use these correctly in your circumstances.
Risks
In the first week after the procedure, you may experience hazy or blurred vision. It can take up to a month for this to resolve fully. Avoid touching or rubbing your eyes where possible.
Risks include:
- Bacterial infection
- Delayed epithelial healing
- Corneal scarring and haze (opacity)
However, complications due to PTK are rare as it is a highly safe and effective procedure.
Benefits
In addition to being a safe procedure with a low complication rate, we see PTK success rates as high as 90%. It gives us a lot of control over your corneal ablation and provides a smooth base for your epithelium.
As this procedure does not involve creating a flap, there is no risk of flap-related complications, such as displacement or detachment. Unlike some options, this procedure is also suitable for people with thin corneas.
During the procedure, we are also able to improve your vision by correcting refractive errors using laser eye treatment. Our ophthalmologist will discuss this option and your suitability, should you want this.
PTK treatment video FAQs
PTK stands for phototherapeutic keratectomy. PRK stands for photorefractive keratectomy. In both lasers, excimer laser is employed on the cornea, but the role that they offer are different. PTK is used to treat a corneal pathology or disease such as recurrent corneal erosion or corneal scars or in keratoconus. PRK, photorefractive keratectomy, is a purely refractive procedure used to correct any prescription you may have, which may be myopia or astigmatism. The most common side effect of laser PTK is pain. After the surgery, you will experience pain for a few days while your eyes heal and settle down. Often the pain settles down and standard painkillers are sufficient to help with the pain. Additionally, there is a risk of an infection or a haze affecting your vision, but this is rare. You may also notice a change in your prescription after surgery. Often, patients take advantage of this to correct any myopia or short-sightedness that they may have. PTK stands for phototherapeutic keratectomy. In laser PTK, we use excimer laser to treat corneal conditions such as recurrent corneal erosions and remove or reduce scar tissue on the cornea or treat other conditions such as keratoconus.
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