Photo Therapeutic Keratectomy (PTK) Treatment
What is photo-therapeutic keratectomy?
Photo-Therapeutic Keratectomy is a type of laser surgery used to treat corneal conditions or injuries affecting the cornea’s outer surface layer (epithelium). The laser we use is similar to the one we use for vision correction. However, we use PTK to treat painful erosions or abnormalities instead of correcting vision.
To determine if this procedure is necessary, our ophthalmologist may perform an eye examination and several other investigations, depending on the cause. These include corneal topography, ocular coherence tomography (OCT), anterior segment OCT, and full refraction.
Who needs PTK?
People with corneal dystrophy, scarring, or conditions such as recurrent corneal erosion may need PTK. In these conditions, the corneal epithelium is loose and starts to separate from the rest of the cornea. We often recommend topical treatments before surgical procedures.
Other conditions it may help with include:
- Bullous keratopathy
- Spheroidal degeneration
- Calcium band keratopathy
- Salzmann nodular degeneration
You may also need it before other surgeries, such as cataract surgery, pterygium surgery or keratoplasty. In some cases, it is a less invasive alternative to corneal keratoplasty and can be more effective.
Recurrent corneal erosion (RCE)
RCE occurs when the corneal epithelium is weakened from previous trauma or due to underlying corneal disease. The eyes are frequently painful as this surface layer breaks down, due to this weakness. When medical therapy is ineffective at controlling these episodes, we recommend PTK. It improves the adhesion of the epithelium to the underlying corneal layers and reduces the frequent recurrences experienced in this condition.
Corneal scars and opacities
Scarring from previous trauma or infection and opacities from underlying corneal disease can affect your vision. We can use this treatment to remove scars and opacities in the cornea’s surface layer, improving your vision. We can also use it to reduce the haloes and glare experienced with corneal dystrophies, such as granular corneal dystrophy.
Before we begin, we apply a topical or local anaesthetic to prevent pain. During PTK, we use an alcohol solution or the excimer laser to remove a thin layer of corneal epithelium to uncover healthy tissue.
Then, we take out thin layers of corneal tissue until you have a smooth corneal surface. We may need to use a masking fluid to highlight areas that require further ablation and help smooth the cornea.
After this, we use a slit lamp to check if we have removed enough tissue. Once we are satisfied with the results, we place a bandage contact lens over your eye. The bandage contact lens allows your eye to heal more comfortably and limits post-operative pain.
As your eye heals, you will need to use antibiotic eye drops to prevent infection, as well as lubricating eye drops and ointment. You may need to use these for up to a month after the procedure. Our ophthalmologist, Mr Tariq Ayoub, will teach you how to use these correctly in your circumstances.
In the first week after the procedure, you may experience hazy or blurred vision. It can take up to a month for this to resolve fully. Avoid touching or rubbing your eyes where possible.
- Bacterial infection
- Delayed epithelial healing
- Corneal scarring and haze (opacity)
However, complications due to PTK are rare as it is a highly safe and effective procedure.
In addition to being a safe procedure with a low complication rate, we see PTK success rates as high as 90%. It gives us a lot of control over your corneal ablation and provides a smooth base for your epithelium.
As this procedure does not involve creating a flap, there is no risk of flap-related complications, such as displacement or detachment. Unlike some options, this procedure is also suitable for people with thin corneas.
During the procedure, we are also able to improve your vision by correcting refractive errors using laser eye treatment. Our ophthalmologist will discuss this option and your suitability, should you want this.
Book an appointment
If you often experience pain due to recurrent corneal erosion, you should not let it continue. Act today and speak to one of our consultant ophthalmologists. Our highly skilled specialists will provide a thorough consultation and recommend any necessary diagnostic tests before determining the best treatment for you. Get in touch to learn more.