PHOTOTHERAPEUTIC KERATECTOMY (PTK) - A SUCCESSFULL TREATMENT FOR THIEL - BEHNKE DYSTROPHY AND ITS RECURRENCES
Thiel - Behnke dystrophy is a hereditary form of anterior stromal dystrophy first described in 1967.
Patients: 5 members of the original family of 1967 were re - examined at the University Eye Hospital, Kiel. A phototherapeutic keratectomy was performed in 6 eyes because of the typical honeycomb corneal surface irregularity and superficial haze. 2 of these eyes had a recurrence of the primary disease on the graft. 4 eyes were untreated so far. The best spectacle corrected visual acuity preoperatively was between 20/125 and 20/40. For all treatments the MEL 60 excimer laser (Aesculap Meditec) was used. To even out the peaks and valleys of the irregular surfaces, modulating agents were applied in decreasing concentrations. The follow- up period is up to 3 years.
Results: All eyes showed a significant visual improvement postoperatively with a best spectacle corrected visual acuity of 20/32 and higher. The maximum amount of hyperopic shiff was + 2.5 D. In the 2 postkeratoplasty eyes with the longest follow-up after PTK, the original disease began to recur. A central comeal thickness of 470 pm and 510 pm was measured with pachometry.
Conclusion: Phototherapeutic keratectomy is a successful therapy for Thiel - Behnke dystrophy resulting in a quick recovery of patients and their vision. Recurrences after penetrating keratoplasty or after PTK can be positively retreated. A (re-) keratoplasty may be postponed or avoided.
University Eye Hospital Kiel, Hegewischstr.2, D - 24105 Kiel