Scar Removal

PTK (Photo Therapeutic Keratectomy) is a phototherapeutic keratectomy operation performed with an excimer laser. Phototherapeutic keratectomy primarily aims to reduce the scar. After a portion of the scar is removed, the cornea relaxes over the next few months, which helps to reduce its irregular curvature. Corneal curvature correction is performed 4 to 6 months later during a second laser operation, PRK (Photorefractive Keratectomy) guided by wavefront technology.

If a corneal scar is shallow and small – opacities extend to a maximum of ¼ of the corneal thickness – they can be removed in a way that avoids corneal transplantation. The PRK procedure, which involves smoothing or “polishing” with an excimer laser, is an effective method for superficial corneal opacities and scars.

Course of the operation:

• The operation lasts from a few seconds to a few minutes, is painless, and is performed on an outpatient basis.
• Eye drops are usually sufficient for anesthesia – eye anesthesia lasts for 15-30 minutes after the procedure.
• Tiny particles are removed from the opaque area – the wound heals within approximately three days.

In the case of deeper and more extensive opacities, the upper layer of the cornea (epithelium) can first be removed to precisely remove the actual opaque parts of the cornea, scars, or deposits using a laser. The deeper the corneal tissue is removed, the greater the likelihood that the procedure will cause the patient to become somewhat farsighted. As a rule, for every 20 micrometers of tissue removed, the patient’s vision shifts by 1 diopter towards farsightedness.

Thanks to the excimer laser and a special laser profile, diseased tissue can usually be removed, and the cornea gently “polished,” eliminating the need for a transplant.

After the operation, a dressing is applied to the eye. Optionally, a protective contact lens is used. Post-operatively, very rarely, infectious keratitis or ulcers may develop under the contact lens applied as a dressing. Immediate ophthalmological examination and treatment are then necessary.

• More severe pain, along with tearing, burning, eye redness, photophobia, and a foreign body sensation in the eye – lasting for approximately 24 hours.
• Mild eye pain – subsides after approximately 4 days.
• Hypersensitivity of the eye to external stimuli.
• Significant visual disturbances – excessive light sensitivity and the formation of halos around light sources (halo effect), which may last for several months.
• Slightly worse vision at dusk and in darkness – in the first months after the operation.

NOTE: Slight or moderate opacities in the treated areas of the cornea may appear approximately one month after the operation, but they will gradually disappear within four months and usually vanish completely after about two to three years.two procedures.

Serious complications with PTK occur so rarely that it is not even possible to provide a statistical probability; however, it should be remembered that previous illnesses and individual patient characteristics may influence the frequency of complications.

In isolated cases, the healing process is so strong that scarring may occur, necessitating another procedure, which in many cases improves the situation. However, this is most often performed several months after the initial operation.

Post-operative complications may include side effects of medications prescribed by the ophthalmologist, such as a hypersensitivity reaction of the eye surface to preservatives contained in eye drops, intolerance to antibacterial medications, or an increase in intraocular pressure induced by cortisone-containing drops.

The corneal scar removal procedure can restore complete or partial transparency to an opaque cornea. If the PTK method is used to treat a ruptured corneal surface, the upper layers of corneal cells can generally stabilize in such a way that no new ruptures appear in the affected area.