Excimer laser phototherapeutic keratectomy in conjunction with mitomycin C in corneal macular and granular dystrophies

ABSTRACT Purpose: To evaluate the visual outcomes, recurrence patterns, safety, and efficacy of excimer laser phototherapeutic keratectomy (PTK) in conjunction with mitomycin C (MMC) for corneal macular and granular diystrophies. Methods: The patients were divided into two groups. Group 1 included patients with macular corneal dystrophy (MCD) that caused superficial corneal plaque opacities, and Group 2 included patients with granular corneal dystrophy (GCD). Patients in both groups were pre-, peri-, and postoperatively evaluated. The groups were compared in terms of uncorrected visual acuity (VA), best spectacle-corrected VA, presence of mild or significant recurrence, and time of recurrence. Results: Eighteen eyes (nine with MCD and nine with GCD) of 18 patients (10 men and eight women) were included. PTK was performed for each eye that was included in this study. The mean ablation amount was 117.8 ± 24.4 µm and 83.5 ± 45.7 µm in MCD and GCD, respectively, (p=0.18). The postoperative improvement of the mean VA was similar between the two groups before recurrences (p>0.43) and after recurrences (p>0.71). There were no statistically significant differences in the recurrence rate and the recurrence-free period for any recurrence type. Conclusion: PTK was an effective, safe, and minimally invasive procedure for patients with MCD and GCD. PTK in conjunction with MMC was similarly effective for both groups in terms of recurrence and visual outcomes.

摘要
研究目的：评估准分子激光治疗性角膜切削术（excimer laser phototherapeutic keratectomy, PTK）联合丝裂霉素C（mitomycin C, MMC）治疗角膜斑状及格子状营养不良的视力预后、复发模式、安全性及有效性。
研究方法：将患者分为两组，第1组为合并角膜表层斑块混浊的斑状角膜营养不良（macular corneal dystrophy, MCD）患者，第2组为格子状角膜营养不良（granular corneal dystrophy, GCD）患者。对两组患者均开展术前、术中及术后评估，比较两组的裸眼视力（uncorrected visual acuity, VA）、最佳框架眼镜矫正视力、轻度或显著复发情况以及复发时间。
研究结果：本研究共纳入18例患者（男10例，女8例）的18只患眼（其中9只眼为MCD，9只眼为GCD），所有纳入研究的患眼均接受了PTK治疗。MCD组与GCD组的平均切削深度分别为117.8±24.4 µm和83.5±45.7 µm（p=0.18）。复发前，两组的平均视力改善程度无统计学差异（p>0.43）；复发后，该差异同样无统计学意义（p>0.71）。各类复发类型的复发率及无复发期均未表现出显著统计学差异。
研究结论：PTK用于治疗MCD及GCD患者是一种安全有效且微创的手术方式。联合丝裂霉素C的PTK治疗在复发情况及视力预后方面，对两类患者均具有相似的临床疗效。