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What is Phototherapeutic Keratectomy (PTK)?
Phototherapeutic Keratectomy is a surgical procedure to manage different corneal diseases. The cornea is the eye’s most outer layer and acts as a window that covers the front of the eye. PTK is a minor surgical therapeutic treatment that uses an excimer laser to treat mainly diseases of the surface of the corneal or corneal injury, by removing a small outer layer of tissue from the cornea. It is normally used after more traditional treatments have failed. It is done for therapeutic reasons, to correct documented medical eye issues.
What types of eye disease is PTK used to treat?
Corneal dystrophies such as granular dystrophy, scars on the cornea and a condition called recurrent epithelial erosion syndrome (REES), when the outer layer (epithelium) of the cornea wears away or blisters, and in most cases this occurs spontaneously. Symptoms are similar to a corneal abrasion and include: the feeling that something is in your eye, pain and soreness of the eye, redness of the eye, light sensitivity, tearing or blurred vision.
What does the procedure involve?
In PTK the first layer of the cornea, the epithelium, is removed using an alcohol solution, the excimer laser is applied to the eye removing a thin layer. In theory, this provides a more sound base layer for healing of the erosion, allowing the corneal epithelium cells to heal all in one sheet, making the healing process more complete over the entire surface. After the surgery a contact lens bandage is put in place to provide a healing environment and reduce pain. Your surgeon will also prescribe for you a regimen of antibiotic, steroid eye drops as well as moisterising eye drops. It is important that you use the drops as these are medicine to help your eye heal and relieve any discomfort.
What will my recovery from PTK involve?
This will involve taking things easy for a couple of days. Take a few days off work and use the antibiotic eye drops (and painkillers) to ease any discomfort or pain. Don’t touch or rub your eye. Wearing a plastic eye shield (similar to an eye patch) can help. Your eyesight will be blurry or hazy for the first week but this will settle down after a month, with full improvement by the end of three-six months. Have someone drive you to and from your surgery appointment as it will be a week before you are able to drive.
Is PTK the same as LASIK?
Phototherapeutic Keratectomy is very similar to laser vision correction surgery. The preparation, procedure and post-operative care are the same in both types of surgery. The main difference is that PTK is used to treat the surface level corneal disease and not to correct vision. LASIK is a vision correction procedure performed to remove the need to wear glasses or contact lenses. In LASIK a flap is created.
In PTK no flap is created, and no vision correction reshaping is done. However, PTK can sometimes be used with photorefractive keratectomy (PRK) to teat any scarring as well as to correct a refractive error, providing both a medical and cosmetic application. Your eye specialist can advise you about this procedure if your goal is also to correct your vision.
Is PTK successful?
PTK has been done for over 20 years and research studies show it is an effective treatment for corneal erosion syndrome with a success rate of over 90%. Some patients may require more than one PTK laser treatments. The laser treatment is minimally invasive and provides long-term results. PTK was approved by the U.S. Food and Drug Administration (FDA) in 1995 for the treatment of anterior corneal pathologies.
What are the risks in PTK surgery?
PTK is a safe and permanent procedure but like any form of surgery it does have a small amount of risk. This includes bacterial infection or corneal haze. These are usually mild and tend to disappear over a period of time, although they can be permanent in a small number of cases. Your eye specialist will discuss these risks with you during the consultation as well as assessing your suitability for PTK.
At Bowen Eye Clinic, Dr Reece Hall can perform your PTK procedure in our purpose built surgical facility. Phone 0800 69 2020 for an assessment. Appointments can be made for Wellington, Palmerston North, Waikanae or Nelson.