Phototherapeutic Keratectomy for the Treatment of Subepithelial Fibrosis and Anterior Corneal Scarring After Descemet Stripping Automated Endothelial Keratoplasty
Awdeh, Richard M. MD; Abbey, Ashkan M. MD; Vroman, David T. MD; Ying, Michelle S. MD; Goldman, David MD; Kymionis, George MD, PhD; Yoo, Sonia H. MD
Purpose: To describe the use of phototherapeutic keratectomy (PTK) and transepithelial photorefractive keratectomy (PRK) for the treatment of subepithelial fibrosis and anterior corneal scarring after Descemet stripping automated endothelial keratoplasty (DSAEK).
Methods: The settings included the Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, and Carolina Cataract and Laser Center, Ladson, SC. Two patients with Fuchs endothelial dystrophy were noted to have anterior corneal opacities and corneal decompensation before DSAEK. Although both patients demonstrated improvement in corneal edema after DSAEK, they were left with residual anterior corneal opacities that were visually significant. The opacities were treated with excimer laser photoablation.
Results: Both patients demonstrated an improvement in best-corrected visual acuity after elimination of the anterior corneal opacity using PTK or transepithelial PRK.
Conclusions: Excimer laser ablation is an effective option for the treatment of residual subepithelial fibrosis and anterior corneal scarring after DSAEK. When appropriate, use of PTK or PRK can also eliminate residual refractive error.