Therapeutics and Clinical Risk Management (Apr 2023)
Topography-Guided Transepithelial Photorefractive Keratectomy for the Treatment of Persistent and Visually-Significant Adenoviral Corneal Infiltrates
Abstract
Leopoldo Spadea, Lucia Di Genova, Edoardo Trovato Battagliola, Maria Pia Paroli Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Rome, ItalyCorrespondence: Leopoldo Spadea, Head Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Via Benozzo Gozzoli 34, Rome, 00142, Italy, Tel +39 06 519 32 20, Fax +390688657818, Email [email protected]: To evaluate visual and refractive outcomes of customized photorefractive keratectomy (PRK) in subjects with persistent subepithelial corneal opacities secondary to adenoviral epidemic keratoconjunctivitis (EKC).Patients and Methods: Prospective study, which recruited patients with persistent and visually-significant post-EKC corneal opacities unresponsive to prolonged topical therapy (6 months or more). Outcome measures: uncorrected and best-corrected distance visual acuity, subjective refractive astigmatism, keratometric astigmatism, spherical equivalent, minimum corneal thickness, and corneal morphological irregularity index. Subjects were followed for 12 months post-treatment.Results: Eighteen eyes of 18 patients aged between 32 and 75 years treated with topography-guided transepithelial PRK with iRes excimer laser (iVIS Technologies, Taranto, Italy) from June 2020 to July 2021. After 12 months, the mean UDVA improved from 1.0± 0.00LogMAR pre-op to 0.15± 0.154LogMAR, and the mean CDVA improved from 0.4± 0.41LogMAR pre-op to 0.0± 0.00LogMAR. With respect to UDVA, all treated eyes (100%) showed an improvement of 6 ETDRS lines or more and with respect to CDVA, 9 out of 18 eyes (50%) showed an improvement of 6 ETDRS lines or more. The mean ablation depth was 54.7± 5.9μm. A statistically significant improvement was observed in all topographic indices. No infiltrate recurrence, post-treatment corneal haze, ocular hypertension or other side effects were observed throughout the follow-up period.Conclusion: Topography-guided PRK could be considered an effective and safe treatment option to improve visual acuity in patients affected by persistent and visually-significant subepithelial corneal infiltrates caused by EKC.Keywords: adenoviral epidemic keratoconjunctivitis, subepithelial corneal opacities, topography-guided transepithelial PRK
