Subtotal Transepithelial Phototherapeutic Keratectomy with Mitomycin C Application for Central Corneal Opacities-Three Case Series

Author(s): Tamer Adel Refai

Purpose: To evaluate the beneficial effects of transepithelial subtotal phototherapeutic keratectomy (PTK) with mitomycin C application for corneal opacities on patients’ visual acuity.

Methods: Three cases with central corneal opacities were subjected to transepithelial subtotal (PTK) using Excimer laser ablation with mitomycin C (0.02%) application for 2 minutes, the first case with a central post-PRK with mitomycin corneal scar 98 µ depth, where PTK ablation depth only 70 µ (thin cornea=430 µ), the second case with a central post-traumatic corneal scar 121 µ depth, with PTK ablation depth only 70 µ (thin cornea=480 µ) and the third case with right corneal (granular) dystrophy, with opacity level was 200 µ, where PTK of only 100 µ was done (young female patient).

Results: The BCVA increased from 0.2 to 0.7 in case 1 and from 0.2 to 0.5 in case 2 and from 0.05 to 0.5 in case 3, without evidence of residual haze in case 1, and with minimal residual haze in case 2 and case 3.

Conclusion: In the presence of relatively non-superficial corneal opacities of various causes, subtotal transepithelial phototherapeutic keratectomy with mitomycin C application can result in marked improvement of visual acuity without the need for keratoplasty.