Photo-Therapeutic Keratectomy, or PTK, is an eye laser surgery procedure that is performed to correct recurrent corneal erosions when other, more traditional treatments have failed. Typically an RCE begins with a simple scratch or tear in the cornea, often called a corneal abrasion. Most heal well with little intervention other than antibiotics and topic ointments such as Muro 128, but in some cases, the injury doesn't heal, and any superficial healing continues to be scraped off by the eyelid, thus causing a recurrent corneal erosion. A first line of treatment for an RCE is a bandage contact lens, but if sustained healing doesn't occur, surgery is often recommended.
What is PTK Eye Laser Surgery?
Photo-Therapeutic Keratectomy laser surgery is done specifically to treat cornea injury or disease issues such as scars on the cornea or other types of corneal surface disease, including recurrent erosions of the cornea. Similar to PRK, this type of eye surgery does not include vision correction. It is done for therapeutic reasons, to correct documented medical eye issues.
In PTK, the first layer of the cornea, the epithelium, is removed using an alcohol solution, and the excimer laser is applied to the eye, taking off a minute layer. In theory, this provides a more sound base layer for healing of the erosion, and also allows the corneal epithelium cells to heal all in one "sheet" – this making healing more likely overall. Following the surgery, a bandage contact lens is put in place to allow healing and reduce pain. There is also a regimen of antibiotic, steroid and pain reducing eye drops that must be followed, as well as the use of moisturizing eye drops.
How is PTK Different From Lasik or PRK?
Photo-Therapeutic Keratectomy is a laser surgery procedure that is very similar to the more well know vision correction surgery know as PRK. Preparation, the procedure itself, and post-op are identical in both types of surgery. The main difference is that in Photo-Therapeutic Keratectomy , no vision correction is done. The main purpose is "is to treat surface level corneal disease and NOT to remove the need to wear glasses or contact lenses." [1]
PTK differs from Lasik laser surgery in two main ways [4]. In Lasik, which is a vision correction surgery, a flap in the cornea is created. The eye is reshaped below the flap, which is then replaced after the surgery. Lasik is not a therapeutic procedure and is not used to correct medical issues of the cornea.
In PTK, no flap is created, making it appropriate for those with thin corneas or dry eye. Also, in PTK no vision correction reshaping is done. Lasik, PRK and PTK surgeries are similar, but done for different reasons, and the recovery in PTK may be a bit longer.
Success of Photo-Therapeutic Keratectomy Eye Laser Surgery
PTK has been done successfully for over 10 years, since the advent of the excimer laser and its use in therapeutic treatments. Research into eye laser surgery [2] has shown that this can be an effective way to treat a recurrent corneal erosion. Some studies have shown "close to an 85 percent success rate in corneal repair" using Photo-Therapeutic Keratectomy [3].
When treating a recurrent corneal erosion, traditional courses of treatment should be considered first. Those include antibiotics such as Vigamox, lubricating eye ointments such as Muro 128 and bandage contact lenses. If those treatments fail, ophthalmologists may choose to use an eye laser surgery procedure known as Photo-Therapeutic Keratectomy, or PTK, as this treatment has been shown to be an effective way to surgically treat an RCE [5].
Disclaimer: This article is intended for informational purposes only. Those with eye injuries or those contemplating eye laser surgery should seek medical attention immediately and follow their doctor’s advice on treatment.
Sources:
[1] Medic8.com. Photo Therapeutic Keratectomy - PTK Laser Eye Surgery (accessed June 9, 2010).
[2] Eye Search.co.uk. Photo-Therapeutic Keratectomy (accessed June 9, 2010).
[3] National Eye Institute. Facts About The Cornea and Corneal Disease (accessed June 9, 2010).
[4] Refractive Surgery News. PRK Laser Eye Surgery (accessed June 9, 2010).
[5] National Center for Biotechnology Information. Phototherapeutic Keratectomy for Recurrent Corneal Erosions (accessed June 9, 2010).
