Anterior segment optical coherence tomography-guided transepithelial phototherapeutic keratectomy for scarring of the central cornea following pterygium excision

AIM:To report the outcomes of patients undergoing anterior segment optical coherence tomography-guided transepithelial phototherapeutic keratectomy(ASOCT T-PTK)for central corneal scarring after pterygium excision.METHODS:The charts of 11 eyes of 10 patients that underwent ASOCT T-PTK following excision of visual axisinvolving pterygia were retrospectively reviewed from a single private practice institution.The visual outcomes and corneal topographic findings were evaluated 4±1 mo after pterygium excision and 6±2 mo after transepithelial phototherapeutic keratectomy(T-PTK).RESULTS:All 11 eyes tolerated both the pterygium excision and T-PTK procedure well without any significant intraoperative or postoperative complications.Uncorrected distance visual acuity(UDVA)and manifest refraction corrected distance visual acuity(CDVA)improved after pterygium excision(P=0.03 and P=0.05,respectively).The UDVA and CDVA improved further after T-PTK(P=0.004 and P=0.002,respectively).The topographic surface asymmetry index,topographic surface regularity index,and topographic projected visual acuity significantly improved after T-PTK(P=0.0092,P=0.0022,and P=0.0002,respectively).None of the subjects lost any lines of CDVA,developed recurrence of pterygia or required keratoplasty during the postoperative period.CONCLUSION:ASOCT T-PTK can provide excellent visual and anatomic outcomes in patients with central corneal scarring after excision of visual axis-involving pterygia.