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Phototherapeutic keratectomy (PTK) is a minor eye surgery treatment for surface-level corneal disease.

You may need this laser procedure if you have certain corneal conditions that affect your vision.

Here’s what you need to know about PTK and how it differs from LASIK surgery and similar procedures.

What’s a Phototherapeutic Keratectomy?

When corrective lenses or medications can’t treat a diseased cornea, surgery may become necessary.

Phototherapeutic keratectomy (PTK) is a type of laser surgery treatment for corneal conditions or injuries affecting the cornea’s outer surface layer.

You may need a PTK if you have corneal conditions affecting your vision, including:

• Corneal dystrophies — These are a group of eye diseases that cause abnormal opacities in the cornea. They include band keratopathy and inherited stromal dystrophies. They may cause a range of symptoms, including severe vision impairment.
• Corneal scars — These can result from physical trauma, injuries, infections such as viral keratitis, or other conditions that affect the clarity of the cornea and vision.
• Recurrent corneal erosions — When the cornea’s outermost layer separates from the underlying layers, this can cause pain, watering eyes, and blurred vision.
• Salzmann’s nodular degeneration — This condition causes nodules to form on the cornea and irregular corneal surfaces. Symptoms can include decreased vision, foreign body sensation, pain, tearing, and red eye. However, sometimes, there are no symptoms at all.

You may also need PTK before other surgeries, such as cataract surgery, pterygium surgery, or keratoplasty.

What to Expect During PTK

Here’s what to expect during your PTK procedure:

1. An eye doctor will usually apply a topical or local anesthetic to prevent pain before the procedure.
2. They’ll then remove the thin layer of corneal epithelium, or the eye’s outermost layer.
3. The doctor will then use a laser to remove thin layers of corneal tissue until you have a smooth, healthy corneal surface. At times, they may use a masking fluid to spotlight areas that require further smoothing.
4. When the doctor has effectively removed the affected corneal layers, they may then place a soft, overnight-wear, bandage contact lens over your eye. This will allow for quick and safe healing. It’ll also limit post-surgery pain.
5. Your doctor will prescribe antibiotic eye drops to prevent infection, as well as lubricating eye drops and ointment to help your eye heal. You may need to use them for up to a month after surgery.
6. The entire procedure often takes less than 30 minutes. It’s a safe surgery with a low complication rate. Studies cited in the journal Ophthalmology and Eye Diseases have shown PTK success rates between 74% to 100% for resolving symptoms.

What’s the recovery time for PTK?

After the procedure, you may experience some pain for two to three days, but eye drops can help with any discomfort.

Possible early side effects include dry eyes, fluctuating vision, glare sensitivity, halos and starbursts around lights, infection, and corneal thinning.

During this time, slightly red or swollen eyes and blurry vision are normal.

Complete recovery can take three to six months, but you can get back to your daily lifestyle within days or weeks.

Is PTK the Same as LASIK?

Although the lasers for PTK and LASIK are similar, PTK treats surface-level corneal diseases and LASIK is solely for vision correction.

LASIK is a vision correction procedure that removes the need for glasses or contact lenses. This procedure creates a flap in the cornea. PTK doesn’t create a flap or perform vision correction reshaping.

PTK can still correct vision by treating eye diseases that cause poor vision.

Symptoms of Corneal Disease

Corneal disease can present with a variety of symptoms, depending on the specific condition and its severity. Here’s a list of common symptoms associated with corneal disease, according to research published in StatPearls:

• Blurred vision — Reduced clarity of vision, which may fluctuate or remain consistently unclear.
• Cloudiness — A cloudy or opaque appearance of the cornea.
• Decreased vision — Gradual or sudden loss of vision clarity.
• Difficulty with night vision — Trouble seeing well in low-light conditions.
• Discharge Unusual eye discharge that’s clear, yellow, or green.
• Excessive tearing — Production of more tears than usual or watery eyes.
• Eye pain or discomfort — Ranging from mild irritation to severe pain.
• Foreign body sensation — Feeling as though there’s something stuck in the eye.
• Hazy vision — A feeling of foggy or unclear vision.
• Headaches — Associated with eye strain or discomfort.
• Redness — Increased redness in the eye, often visible in the white part of the eye.
• Sensitivity to light — Discomfort or pain when exposed to bright lights.
• Swelling — Visible swelling or puffiness around the eye.
• Vision distortion — Distorted or irregular vision, such as seeing halos or glare around lights.

Expert Care at the UPMC Vision Institute

The UPMC Vision Institute’s cornea services department diagnoses and treats corneal diseases and disorders. These include corneal dystrophies, cataracts, infections, and dry eye.

The Institute uses advanced laser technology and surgical techniques, such as phototherapeutic keratectomy or corneal transplantation. These can restore an individual’s visual clarity and enhance their quality of life.

Call the UPMC Vision Institute at 412-530-5406 to learn more or make an appointment, or visit https://www.upmc.com/services/eye for more information.