[Combined transepithelial PTK and topography-guided PRK for treatment of trauma-related corneal scarring].

Background: Corneal scars can severely impair visual performance and treatment can be challenging. The study aimed to evaluate a promising minimally invasive option in the treatment of corneal scars using transepithelial topography-guided ablation.

Methods: This retrospective interventional study involved four eyes of four patients who developed corneal scarring and irregular surfaces due to trauma and were treated with topography-guided photorefractive keratectomy (TG-PRK) between 2017 and 2020. The ablation profile was calculated in all four cases using CRS-Master (Zeiss, Jena, Germany). The main outcome measures were uncorrected and best-corrected distance visual acuity, manifest refraction and corneal regularity by topographic images. The mean age was 34.75 ± 15.39 years and the follow-up time was 6 months for all patients.

Results: In three cases full subjective refraction was corrected in one session and one patient had a refractive error of +0.5 D. Only corneal surface smoothing without additional refractive correction was performed in this case. All four patients showed improvement in uncorrected (2-3 Snellen lines) and corrected (3 Snellen lines) distance visual acuity. No complications occurred during or after the treatment and there was no reduction of visual acuity in any case.

Conclusion: The use of TG-PRK in patients with corneal scarring improves visual acuity in selected cases. In myopic patients most of the refractive error can also be corrected in a single session.