Recurrent corneal erosion following uneventful IntraLASIK treated by phototherapeutic keratectomy.

PURPOSE: To report on phototherapeutic keratectomy (PTK) in myopic patients who developed spontaneous recurrent corneal erosions (RCE) following IntraLASIK. METHODS: Recurrent corneal erosions developed spontaneously 3-6 months following IntraLASIK in 4 eyes of 4 myopic patients. Diffuse lamellar keratitis (DLK) subsequently developed. Initially, all patients underwent mechanical scraping of the loose epithelium. The erosion healed but recurred after 2-4 months. Phototherapeutic keratectomy was performed following scraping of the whole loose flap epithelium. The ablation diameter was 6.5 mm, transition zone was 2.7 mm, and the depth was 12 µm. This program was followed by a refractive laser treatment to correct +0.75 diopter at a zone of 6.0-9.0 mm. RESULTS: Recurrent corneal erosions healed completely following PTK within 8-10 days and DLK disappeared gradually within 9-12 days. Steroid drops were continued for 6-10 weeks according to degree of stromal haze. Final refraction revealed no significant change. Visual rehabilitation was noted to be slow. No patient lost best-corrected visual acuity. A +1-degree reticular haze was noted in all patients 4.5 years following treatment. The patients remained asymptomatic and corneal erosion did not recur during the follow-up period. CONCLUSIONS: Phototherapeutic keratectomy was found to be an effective treatment for late spontaneous RCE after IntraLASIK and prevented recurrences. A mild stromal haze remained after laser treatment without loss of best-corrected visual acuity.