ĐÁNH GIÁ HIỆU QUẢ VÀ AN TOÀN ĐIỀU TRỊ BỆNH LÝ GIÁC MẠC DẢI BĂNG BẰNG LASER EXCIMER

Abstract

Introduction: Band keratopathy causes vision impairment and uncomfortable ocular symptoms. Objective: To evaluate the efficacy and safety of excimer laser phototherapeutic keratectomy (PTK) in the treatment of band keratopathy. Subjects and Methods: A prospective case series study was conducted on 24 eyes of 18 patients diagnosed with band keratopathy. Patients underwent PTK at the Ho Chi Minh City Eye Hospital from September 2023 to June 2024. Visual acuity, refraction, subjective symptoms, corneal clarity, and corneal parameters on AS-OCT and Pentacam were compared before and after surgery. The follow-up period was 6 months. Results: The mean age was 20.96 ± 14.92 years, with the 10-20 age group being the most common (44.44%). The primary cause was underlying ocular diseases, with uveitis accounting for 72.22%, followed by retinal disorders at 22.22%. Postoperatively, subjective symptoms such as foreign body sensation and glare were completely resolved in all patients. Mean best-corrected visual acuity (BCVA) improved from 0.09 ± 0.08 preoperatively to 0.33 at 6 months (p < 0.001). The percentage of eyes with BCVA ≥ 0.5 increased from 0% to 41.66%. Corneal clarity improved significantly, with 66.67% of eyes achieving complete clarity at 6 months. Refractive status also changed in eyes with measurable objective refraction, showing a postoperative hyperopic shift of more than +0.2 diopters and a reduction in astigmatism. Central corneal thickness, corneal power, and corneal astigmatism all showed a statistically significant decrease (p < 0.05). The most common complication was corneal haze (66.67%), which mostly responded to treatment. No cases of recurrence, infection, or corneal ectasia were recorded. Conclusion: Excimer laser phototherapeutic keratectomy is an effective and safe treatment for band keratopathy, significantly improving corneal clarity, visual acuity, and subjective symptoms for patients.