Therapeutic Laser Treatments (PTK)

For corneal scarring or injury or to prevent recurrent erosions

PhotoTherapeutic Keratectomy is a type of laser eye surgery used for a range of problems affecting the superficial layers of the cornea. PTK uses the same excimer laser as in LASIK, LASEK or TransPRK. Instead of reshaping the cornea to correct your vision, PTK can remove scars, opacities or treats painful recurrent erosions.

If you already wear glasses or contact lenses and need to have a therapeutic laser treatment it may be possible to correct your vision simultaneously. As an alternative to PTK, PhotoRefractive Keratectomy (PRK) can, in selected cases, correct short-sightedness (including astigmatism) in addition to the primary therapeutic goal. 

PTK treatment is normally covered by insurers; PRK, LASEK & TranPRK are not covered.

Recurrent Corneal Erosion

The surface (epithelium) skin layer of the eye is only secure if it is ‘stuck down’ to its base layer. After a corneal abrasion or scratch, sometimes the new cell layer doesn’t stick properly. Since this layer has lots of nerve endings, the slightest disruption can cause intense pain as it moves and becomes unstable. This commonly occurs at night or the early morning when your eyelid sticks to the surface of the eyeball.

PTK works by freshening up the base layer so that a new sheet of epithelial cells sticks down properly.

Superficial corneal scarring

If you have had a previous injury or infection in the eye, sometimes residual scarring can affect your vision. This is particularly problematic if any scarring is covering all or part of the pupil. Phototherapeutic keratectomy (PTK) uses laser to remove all or part of a scar to help improve your vision.

Does the procedure hurt?
No. Anaesthetic drops are used to numb the eye so that no pain is felt during the procedure. If you are really nervous, a sedative in the form of a tablet can be given to help you stay relaxed.
How much of the cornea is removed with PTK?
For recurrent corneal erosions, Mr Gore’s standard protocol removes just 15 microns, less than 3% of the central corneal thickness. This is based on recent clinical trial evidence from the University of Hamburg showing success rates of 90% with a single treatment. To remove scars from the front layers of the cornea, the depth of the PTK treatment is programmed based on high-definition scans taken as part of your consultation.
Will my vision be blurred afterwards?
Yes. Initially your vision will be blurred, before beginning to recover during the first week. Depending on the underlying reason for PTK treatment ,it can sometimes take a few weeks for the vision to fully stabilise. You will need to wear a ‘bandage’ soft contact lens for at least one week to support the new epithelial cell layer as it heals. This lens stays in day and night (no need for you to remove it), before being removed by Mr Gore’s team in the clinic.

One advantage of modern laser technology is that the ablation profile is refractively neutral – this means that it is very unlikely that your spectacle or contact lens prescription will change. Similarly, if you don’t currently require spectacles, PTK is unlikely to change that.
What are the risks?
Overall, laser eye surgery is very safe. The risk of a serious complication (e.g. infection, scarring) requiring a corneal transplant to restore vision is approximately 1 in 5,000. This compares with the risk of a serious corneal infection due to the wearing of contact lenses of approximately 1 in 3,000 per year.
Can you correct my short-sightedness at the same time?

This is possible in some patients, depending on the underlying need for treatment and your existing spectacle prescription. Because scars or surface irregularity can affect the accuracy of laser treatment, Mr Gore may advise a two-step plan if you’re keen to additionally correct your short-sightedness: PTK to treat the initial problem, then a few months later PhotoRefractive Keratectomy (PRK) to get rid of glasses.

PTK treatment is normally covered by insurers; PRK is not covered.

Does PTK need to be repeated?
Rarely. The success rate for recurrent erosion treatment are approximately 90%.
PTK for corneal dystrophies sometimes need to be repeated if the original opacities re-occur.

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