Combined PRK and PTK in myopic patients with recurrent corneal erosion.

AIM To study the results of combined photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) in myopic patients with recalcitrant recurrent corneal erosion. METHODS PRK was performed in 16 eyes with the Visx 20/20 excimer laser at a central 6.0 mm zone, following total epithelial scraping. Subsequently, confluent 3.0 mm zones of PTK were ablated at a depth of 6.0 microns, surrounding the zone of PRK. The follow up period ranged from 26 to 42 months. RESULTS Complete alleviation of symptoms was demonstrated and there was no recurrence of corneal erosion. Visual acuity (VA) improved slowly following treatment, with a final uncorrected VA ranging between 6/9 and 6/12. A final myopic spherical equivalent < or = -1.0 D was found in 14 out of 16 eyes. CONCLUSIONS A combination of PRK and PTK is effective in the alleviation of symptoms and prevention of recurrences of corneal erosion. It is suggested that recalcitrant recurrent corneal erosion is a diffuse disease, although it often manifests as a local problem, and therefore extensive excimer laser ablation is required to prevent recurrence and to alleviate symptoms completely.