Abstract：
*Correspondence - Mukhtar Bizrah: m.bizrah@nhs.net OBJECTIVE: To evaluate the efficacy and safety of trans-epithelial phototherapeutic keratectomy (PTK) as a treatment for recurrent cornea erosion syndrome (RCES) in patients with symptoms refractory to conventional treatments.
METHODS: All patients who received PTK treatment for RCES had failed more than one conventional treatment, and were first vetted and approved by the British Columbia public health authority. A retrospective chart review and telephone survey were conducted at the Pacific Laser Eye Centre. Exclusion criteria were ocular co-morbidities potentially affecting treatment efficacy.
RESULTS: This study included 593 eyes of 555 patients (46.2% male; 50.9±14.2 years old) who underwent PTK. The leading identified causes of RCES were trauma (45.7%) and anterior basement membrane dystrophy (44.2%). The most common pre-PTK interventions were ocular lubricants (90.9%), hypertonic solutions (77.9%), and bandage contact lenses (50.9%). 36 eyes had undergone surgical interventions such as stromal puncture, epithelial debridement, or diamond burr polishing. Post-PTK, 78% of patients did not require any subsequent therapies, 20% required ongoing drops and 6 patients (1.1%) reported no symptom improvement. All 6 eyes were successfully retreated with PTK between 11.3±14.9 months from initial PTK. All study patients showed no significant differences in best corrected visual acuity pre vs. postoperatively.
CONCLUSIONS: When compared to other surgical options, PTK is potentially more costly but frequently more effective and has a high safety profile. The third-party public health vetted nature of this study, the high patient satisfaction, and the low recurrence rate of RCES suggest that PTK should be considered at an earlier stage in the management of RCES.
METHODS: All patients who received PTK treatment for RCES had failed more than one conventional treatment, and were first vetted and approved by the British Columbia public health authority. A retrospective chart review and telephone survey were conducted at the Pacific Laser Eye Centre. Exclusion criteria were ocular co-morbidities potentially affecting treatment efficacy.
RESULTS: This study included 593 eyes of 555 patients (46.2% male; 50.9±14.2 years old) who underwent PTK. The leading identified causes of RCES were trauma (45.7%) and anterior basement membrane dystrophy (44.2%). The most common pre-PTK interventions were ocular lubricants (90.9%), hypertonic solutions (77.9%), and bandage contact lenses (50.9%). 36 eyes had undergone surgical interventions such as stromal puncture, epithelial debridement, or diamond burr polishing. Post-PTK, 78% of patients did not require any subsequent therapies, 20% required ongoing drops and 6 patients (1.1%) reported no symptom improvement. All 6 eyes were successfully retreated with PTK between 11.3±14.9 months from initial PTK. All study patients showed no significant differences in best corrected visual acuity pre vs. postoperatively.
CONCLUSIONS: When compared to other surgical options, PTK is potentially more costly but frequently more effective and has a high safety profile. The third-party public health vetted nature of this study, the high patient satisfaction, and the low recurrence rate of RCES suggest that PTK should be considered at an earlier stage in the management of RCES.
摘要：
*通讯-MukhtarBizrah：m.bizrah@nhs.net目的：评估经上皮光疗角膜切除术（PTK）治疗复发性角膜糜烂综合征（RCES）的疗效和安全性对常规治疗无效。
方法：所有接受PTK治疗的RCES患者均有一次以上的常规治疗失败，并首先由不列颠哥伦比亚省公共卫生当局审查和批准。在太平洋激光眼科中心进行了回顾性图表审查和电话调查。排除标准是可能影响治疗效果的眼部合并症。
结果：本研究纳入了555例接受PTK患者的593只眼（46.2%为男性；50.9±14.2岁）。RCES的主要确定原因是创伤（45.7％）和前基底膜营养不良（44.2％）。最常见的PTK前干预是眼部润滑剂（90.9%），高渗溶液(77.9%)，和绷带隐形眼镜(50.9%)。36只眼睛接受了手术干预，如基质穿刺，上皮清创术,或金刚石毛刺抛光。PTK后,78%的患者不需要任何后续治疗，20%的患者需要持续滴注，6例患者（1.1%）报告没有症状改善。从最初的PTK开始的11.3±14.9个月内，所有6只眼均成功接受PTK治疗。所有研究患者在最佳矫正视力前与前没有显着差异。术后。
结论：与其他手术方案相比，PTK可能更昂贵，但通常更有效，并且具有很高的安全性。第三方公共卫生审查了这项研究的性质，患者满意度高,RCES的低复发率表明，在RCES的管理中，应在早期阶段考虑PTK。
方法：所有接受PTK治疗的RCES患者均有一次以上的常规治疗失败，并首先由不列颠哥伦比亚省公共卫生当局审查和批准。在太平洋激光眼科中心进行了回顾性图表审查和电话调查。排除标准是可能影响治疗效果的眼部合并症。
结果：本研究纳入了555例接受PTK患者的593只眼（46.2%为男性；50.9±14.2岁）。RCES的主要确定原因是创伤（45.7％）和前基底膜营养不良（44.2％）。最常见的PTK前干预是眼部润滑剂（90.9%），高渗溶液(77.9%)，和绷带隐形眼镜(50.9%)。36只眼睛接受了手术干预，如基质穿刺，上皮清创术,或金刚石毛刺抛光。PTK后,78%的患者不需要任何后续治疗，20%的患者需要持续滴注，6例患者（1.1%）报告没有症状改善。从最初的PTK开始的11.3±14.9个月内，所有6只眼均成功接受PTK治疗。所有研究患者在最佳矫正视力前与前没有显着差异。术后。
结论：与其他手术方案相比，PTK可能更昂贵，但通常更有效，并且具有很高的安全性。第三方公共卫生审查了这项研究的性质，患者满意度高,RCES的低复发率表明，在RCES的管理中，应在早期阶段考虑PTK。
