Corneal optical coherence tomography before and after phototherapeutic keratectomy for recurrent epithelial erosions

Purpose: To study the representation of corneal structures with optical coherence tomography (OCT) before and after excimer laser phototherapeutic keratectomy (PTK) for recurrent epithelial erosions. Setting: Departments of Ophthalmology, Vivantes Klinikum Neukolln, Berlin, and Medizinische Universitat, Lubeck, Germany. Methods: This prospective study comprised 15 eyes of 14 patients with recurrent epithelial erosions. The central corneal and epithelial thickness as well as the wound-healing response in the anterior corneal stroma were assessed with slit-lamp-adapted OCT before and after PTK. Results: After PTK, the symptoms improved in all patients without loss of best corrected, glare, or low-contrast visual acuity. The mean central corneal OCT thickness was 540 mum +/-28 (SD) preoperatively, 492 +/- 36 mum immediately after epithelial debridement and PTK, and 519 +/- 25 mum after 7 weeks (P < .01). The mean central epithelial OCT thickness changed from 70 ± 13 μm preoperatively to 60 ± 7 μm after 7 weeks (P > .01). Changes in the light-scattering properties in the anterior subepithelial stroma revealed a hyperreflective area with a mean thickness of 46 +/- 13 mum after 7 weeks. Conclusions: Using noncontact corneal OCT, corneal and epithelial thickness changes and the wound-healing response in the anterior corneal stroma could be evaluated after PTK in patients with recurrent epithelial erosions.