Fourier-domain optical coherence tomography-guided phototherapeutic keratectomy for the treatment of anterior corneal scarring.

AIM To evaluate the safety, visual and anatomic outcomes of fourier-domain optical coherence tomography (FD-OCT)-guided excimer laser phototherapeutic keratectomy (PTK) combined with photorefractive keratectomy (PRK) surgery in treating anterior corneal scarring. METHODS Clinical data of 23 eyes of 21 patients with anterior corneal scarring underwent FD-OCT-guided PTK and PRK from Dec. 2014 to Jul. 2016 were reviewed. Patients were assessed for preoperative and postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity (CS), FD-OCT, corneal topography and colour figures of anterior segments. RESULTS The preoperative corneal pathologic conditions included viral keratitis (7 patients, 7 eyes), band keratopathy (2 patients, 4 eyes), corneal dystrophy (4 patients, 4 eyes), traumatic corneal disease (2 patients, 2 eyes) and corneal chemical injury (6 patients, 6 eyes). Mean follow-up time was 10.65 (range, 3-19)mo. UCVA (in logMAR) improved from a mean of 0.79 (95%CI, 0.28-1.29) preoperatively to a mean of 0.45 (95%CI, 0.29-0.62) postoperatively (P=0.021). BSCVA (in logMAR) improved from 0.57 (95%CI, 0.27-0.88) preoperatively to a mean of 0.28 (95%CI, 0.15-0.41) postoperatively (P=0.001). Corneal topographic indices postoperatively showed significant improvement in corneal cylinder (P=0.009), the surface regularity index (P=0.007) and surface asymmetry index (P=0.00). Postoperative spherical equivalent averaged -0.53 diopters (-1.49 to 0.42). No complications were associated with the treatment. CONCLUSION FD-OCT-guided PTK combined with PRK is safe and effective for the treatment of anterior corneal scarring by eliminating or reducing corneal opacities.